Age-dependent impairment of coronary collateral development in humans

Abstract

The purpose of this study was to evaluate whether age influences collateral development in patients with coronary artery disease. The extent of collateral development to the area perfused by the infarct-related artery was graded, depending on the degree of opacification of the occluded infarct-related artery. We evaluated the extent of collateral development using coronary cineangiography in 102 patients with an acutely occluded infarct-related coronary artery within 12 h after the onset of the first acute myocardial infarction, and who had a history of long-standing effort angina. Well-developed collateral circulation was observed in 54 (53%) of the patients. The patients were divided into two groups based on their age. The prevalence of well-developed collateral circulation in the younger group (< or = 64 years, n = 48) was 69% (33 of 48), being significantly (P = 0.003) higher than 39% (21 of 54) in the older group (> or = 65 years, n = 54). We conclude that in the presence of stimuli for collateral development i.e., long-standing effort angina accompanied by severe coronary stenosis, the age of patients is a key determinant of collateral development.

Angiographic Evaluation of Coronary Collateral Circulation Patterns in Patients with Coronary Artery Disease Requiring Surgical Revascularization

“…The mean age in the present study was a 59.94 ± 10.13 year which was comparable to that of only diabetic cases in a study from Turkey (in diabetic patients-59.09 ± 8.49 years, in non diabetic patients-58.89 ± 11 years) while CAD was observed at a higher average age in Swiss (64 years) and Japanese studies (62 ± 11 years) [10] [11] [12]. Therefore, it is evident that Indians are being affected at an earlier age.…”

“…In cases with age > 50 years, collaterals were significantly more prevalent compared to less than 50 years (Table 2). Nakae et al [12] also observed higher prevalence of collaterals among cases with age ranging from 55 -63 years, but well developed collaterals were documented less in older patients in their study group while Pohl et al [17] did not find any significant correlation between age and collateral development (measured by coronary flow index). Increasing prevalence of coronary collaterals with age in collateral circulation is more common with RCA than with LAD or circumflex occlusion [19].…”

Coronary artery dominance dependent collateral development in the human heart

“…Furthermore, van der Hoeven et al [22] in their study divided patients into two groups (≤ 64 years and ≥ 65 years) and also found no association between higher age and the development of poor collaterals. Conversely, it differed from the reports of Nakae et al [14] and Sun et al [19] who stated that well-developed collaterals were significantly lower in patients older than > 65 years of age. The disparity in the results may be explained by the difference in the methods of coronary collateral assessment and grading of these channels.…”

“…However, there was no statistically significant difference in the prevalence of excellent collaterals between males and females; therefore, there was no association between the patients' sex and the development of excellent collaterals. Although, the present finding differed from the report of Sun et al [19] who stated that well-developed collaterals was significantly lower in female patients, it confirmed the reports of Fujita et al [4] and Nakae et al [14] who also found no significant difference.…”

Plasma Level of Homocysteine is Inversely-Associated With the Development of Collateral Circulation in Patients With Single-Vessel Coronary Artery Disease

“…Significant coronary narrowing was defined as stenosis of at least 50% of the vessel diameter in any of the main coronary arteries (the left main coronary artery, the left anterior descending coronary artery with its major diagonal branches, the right coronary artery or the circumflex coronary artery with its major marginal one). Collateral vessels were graded according to Rentrop's classification, 15,16 in which 0 = no opacification; 1 = filling of side branches of the artery perfused by way of collateral vessels without visualization of the epicardial segment; 2 = partial filling of the epicardial segment by way of collateral vessels; 3 = complete filling of the epicardial segment by way of collateral vessels. Grading of the collateral vessels was independently performed by 2 angiographers.…”