Abstract 17003: Effect of Angiographic Collaterals on Long-Term Clinical Outcomes in Patients With Chest Pain
Background: Coronary collaterals are an innate protective mechanism that preserves myocardial perfusion in the presence of severe stenoses. The effect of collaterals on long-term clinical outcomes remains controversial.
Methods: The study design was a prospective cohort study of 984 patients with chest pain referred for angiography. Patients were followed for one year after angiography. The primary outcome was the composite endpoint of major adverse cardiac events (MACE) including death, myocardial infarction (MI), and the need for coronary artery bypass graft surgery (CABG) or percutaneous coronary intervention (PCI). Secondary outcomes were the individual endpoints of death, MI, recurrent angina, and need for CABG or PCI following angiography.
Results: 984 patients were followed for 1 year and 233 (24%) had spontaneously visible coronary collaterals at the time of angiography. Patients with collaterals were older (62 ± 11 vs. 60 ± 11 years, p=0.042), men (77% vs. 62%, p<0.001), with higher rates of smoking (66% vs. 54%, p<0.001), hyperlipidemia (86% vs. 78%, p=0.014), and prior MI (32% vs. 22%, p=0.002). During 1 year follow-up, there were no differences in recurrent angina (HR 0.84, 95% CI 0.56 to 1.26; p=0.386), MI (HR 1.44, 95% CI 0.49 to 4.28; p=0.511) the need for CABG or PCI (HR 1.02, 0.65 to 1.61; p=0.925), death (HR 2.48; 95% CI 0.82 to 7.46; p=0.107) or MACE (HR 1.01, 95% CI 0.70 to 1.44; p=0.971) between patients with and without collaterals.
Conclusions: In patients with chest pain referred for coronary angiography the presence of angiographic coronary collaterals does not impact long-term clinical outcomes.
- © 2013 by American Heart Association, Inc.