Coronary collateralization: determinants of adequate distal vessel filling after arterial occlusion

BACKGROUNDThe protective effect of collateral vessels in coronary artery disease (CAD) is well established. Little is known, however, about factors that influence collateral formation. METHODSWe studied the coronary angiograms of 200 consecutive patients with single-vessel coronary artery occlusion. Patients were excluded if obstructive stenoses were present in other vessels or if prior revascularization had been undertaken. Collateral circulation to the occluded artery was graded as ‘poor’ (no or incomplete filling) or ‘rich’ (complete filling). Patient characteristics, including mode of presentation, medications and CAD risk factors, were assessed. RESULTSPositive univariate correlates of rich collaterals included increasing age [odds ratio (OR) 1.03, P = 0.016], ‘statin’ use (OR 2.50, P = 0.005), nitrate use (OR 1.96, P = 0.034), calcium-channel blocker (CCB) use (OR 4.07, P