Impact of Coronary Collaterals on Long-term Prognosis in Patients Treated With Primary Angioplasty

Effect of Coronary Collaterals on Prognosis in Patients Undergoing Primary Percutaneous Coronary Intervention for Acute ST-Segment Elevation Myocardial Infarction: A Meta-Analysis

“…Among the 14 studies, 4 reported multivariable-adjusted hazard ratios or odds ratios of mortality 16,20,22,25 and 1 compared the 2 groups between propensity score-matched populations. 21 It should be noted that the risks of mortality for patients with and without coronary collaterals were also multivariably adjusted in another 2 studies. However, the value of adjusted hazard ratios was not reported.…”

“…For example, the study by Desch et al showed that the incidence of MACE (defined as death or nonfatal reinfarction) in patients with coronary collaterals was lower than those without coronary collateral, 16 whereas the study of Hernandez-Perez et al suggested that the presence of collaterals was not associated with a lower long-term MACE (defined as cardiovascular death, reinfarction, target vessel revascularization, and coronary artery bypass grafting). 21…”

“…31 On the other hand, however, high coronary collaterals may be a marker of more advanced coronary artery disease, which could imply a poorer long-term prognosis. 17,21,26 Additionally, some studies reported that the possible protective role of the coronary collaterals might decrease over time due to regression of collateral function after coronary revascularization. 32,33 Several studies have revealed positive effects of coronary collaterals on survival, while others have demonstrated that patients with and without coronary collaterals have comparable long-term mortality.…”

“…12 However, the definition of the presence of angiographic coronary collaterals varied in each study. Overall, most of the studies compared the outcomes of patients with and without epicardial filling by collateral vessels (Rentrop score 2-3 vs Rentrop score 0-1), [13][14][15][16][17][18][19][20][21][22] whereas 3 studies compared the outcomes of patients with and without coronary collaterals (Rentrop score 1-3 vs Rentrop score 0). [23][24][25] In our metaanalysis, patients were divided into 4 groups in compliance with the Rentrop score in the study by Hara et al and we reclassified the patients into 2 groups, which were those with and without any epicardial filling by collateral vessels.…”

“…A total of 60 articles were chosen for complete review, and finally 14 studies involving 10 411 patients were included in the present metaanalysis. [13][14][15][16][17][18][19][20][21][22][23][24][25][26] All studies were published between 1998 and 2017. The process of selecting studies for the meta-analysis is briefly depicted in Figure 1.…”