Impacts of Established Cardiovascular Risk Factors on the Development of Collateral Circulation in Chronic Total Occlusion of Coronary Arteries

Background: Presence and magnitude of coronary collateral circulation, as an adaptive mechanism has been shown to affect prognosis in patients with ischemic coronary artery disease. Thus far, the clinical determinants of the coronary collateral circulation were not well-established. Objective: The objective of the study is to determine possible relationship between medical history, clinical findings and angiographic evidences of collateral coronary blood flow. Methods: In an observational study, all patients who underwent coronary angiography for the first time with total occlusion in at least one coronary artery were participated in the study from February 2012 to February 2013. To determine the status of collateral flow, patients were divided into 4 groups according to Rentrop classification to detect possible factors that may influence collateral formation. Results: A total of 52 patients met the inclusion criteria and entered the study. Statin therapy (67%), smoking (58%) and a positive family history (19%) were the most frequent findings. According to Rentrop classification, 7 (13.5%) patients were in grade 0, 17(32.7%) in grade 1, 21(40.4%) in grade 2, and 7(13.5%) were classified in grade 3 (Table1). There was significant association between myocardial performance and angiographic findings. There was no statistically significant difference between the grades for any of the risk factors (p value >0.05). Conclusion: Although large epicardial or septal col ateral vessels has been stated to become visible within two weeks after a complete occlusion of a major coronary vessel, our findings suggest that this vessel formation could not be related to medical history and clinical findings of patients.