The Presence of angiographic collaterals in Non-ST elevation myocardial infarction is a predictor of long-term clinical outcomes
Objectives To determine whether the presence of angiographic coronary collaterals is a predictor of long‐term clinical outcomes in patients with non‐ST elevation myocardial infarction (NSTEMI). Background The presence of coronary collaterals on angiography provides prognostic information in patients...
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| Published in | Catheterization and cardiovascular interventions Vol. 83; no. 1; pp. 1 - 8 |
|---|---|
| Main Authors | , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Blackwell Publishing Ltd
01.01.2014
Wiley Subscription Services, Inc |
| Subjects | |
| Online Access | Get full text |
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| Abstract | Objectives
To determine whether the presence of angiographic coronary collaterals is a predictor of long‐term clinical outcomes in patients with non‐ST elevation myocardial infarction (NSTEMI).
Background
The presence of coronary collaterals on angiography provides prognostic information in patients with STEMI, but it is unknown whether they provide prognostic information in patients with NSTEMI.
Methods
This was a prospective cohort study of 931 consecutive patients undergoing coronary angiography of which 269 (29%) had a NSTEMI. Baseline characteristics, angiographic details, and long‐term clinical outcomes including death, recurrent MI, coronary artery bypass graft surgery (CABG), percutaneous coronary intervention (PCI), stroke, and congestive heart failure (CHF) were collected. Each clinical outcome as well as the combined endpoint of death, recurrent MI, CABG, PCI stroke and CHF was compared in subjects with and without collaterals.
Results
At one year, individuals with collaterals had significantly increased rates of the combined endpoint compared with those without (25% vs. 16%, P = 0.0001). On multivariate analysis, the presence of collaterals was a strong predictor of the combined endpoint of death, recurrent MI, CABG, PCI, stroke and CHF (HR 1.95, CI 95% 1.08−3.52; P = 0.027). Similarly, in the subset of 115 patients (43%) in whom the culprit artery was identified, the presence of collaterals was a strong negative predictor (HR 3.71, CI 1.31−10.57, P = 0.014), driven by a 13‐fold increase in subsequent CABG.
Conclusions
In patients with NSTEMI the presence of angiographic coronary collaterals is a predictor of long‐term clinical outcomes primarily driven by increased rates of surgical revascularization. © 2013 Wiley Periodicals, Inc. |
|---|---|
| AbstractList | Objectives
To determine whether the presence of angiographic coronary collaterals is a predictor of long‐term clinical outcomes in patients with non‐ST elevation myocardial infarction (NSTEMI).
Background
The presence of coronary collaterals on angiography provides prognostic information in patients with STEMI, but it is unknown whether they provide prognostic information in patients with NSTEMI.
Methods
This was a prospective cohort study of 931 consecutive patients undergoing coronary angiography of which 269 (29%) had a NSTEMI. Baseline characteristics, angiographic details, and long‐term clinical outcomes including death, recurrent MI, coronary artery bypass graft surgery (CABG), percutaneous coronary intervention (PCI), stroke, and congestive heart failure (CHF) were collected. Each clinical outcome as well as the combined endpoint of death, recurrent MI, CABG, PCI stroke and CHF was compared in subjects with and without collaterals.
Results
At one year, individuals with collaterals had significantly increased rates of the combined endpoint compared with those without (25% vs. 16%, P = 0.0001). On multivariate analysis, the presence of collaterals was a strong predictor of the combined endpoint of death, recurrent MI, CABG, PCI, stroke and CHF (HR 1.95, CI 95% 1.08−3.52; P = 0.027). Similarly, in the subset of 115 patients (43%) in whom the culprit artery was identified, the presence of collaterals was a strong negative predictor (HR 3.71, CI 1.31−10.57, P = 0.014), driven by a 13‐fold increase in subsequent CABG.
Conclusions
In patients with NSTEMI the presence of angiographic coronary collaterals is a predictor of long‐term clinical outcomes primarily driven by increased rates of surgical revascularization. © 2013 Wiley Periodicals, Inc. To determine whether the presence of angiographic coronary collaterals is a predictor of long-term clinical outcomes in patients with non-ST elevation myocardial infarction (NSTEMI).OBJECTIVESTo determine whether the presence of angiographic coronary collaterals is a predictor of long-term clinical outcomes in patients with non-ST elevation myocardial infarction (NSTEMI).The presence of coronary collaterals on angiography provides prognostic information in patients with STEMI, but it is unknown whether they provide prognostic information in patients with NSTEMI.BACKGROUNDThe presence of coronary collaterals on angiography provides prognostic information in patients with STEMI, but it is unknown whether they provide prognostic information in patients with NSTEMI.This was a prospective cohort study of 931 consecutive patients undergoing coronary angiography of which 269 (29%) had a NSTEMI. Baseline characteristics, angiographic details, and long-term clinical outcomes including death, recurrent MI, coronary artery bypass graft surgery (CABG), percutaneous coronary intervention (PCI), stroke, and congestive heart failure (CHF) were collected. Each clinical outcome as well as the combined endpoint of death, recurrent MI, CABG, PCI stroke and CHF was compared in subjects with and without collaterals.METHODSThis was a prospective cohort study of 931 consecutive patients undergoing coronary angiography of which 269 (29%) had a NSTEMI. Baseline characteristics, angiographic details, and long-term clinical outcomes including death, recurrent MI, coronary artery bypass graft surgery (CABG), percutaneous coronary intervention (PCI), stroke, and congestive heart failure (CHF) were collected. Each clinical outcome as well as the combined endpoint of death, recurrent MI, CABG, PCI stroke and CHF was compared in subjects with and without collaterals.At one year, individuals with collaterals had significantly increased rates of the combined endpoint compared with those without (25% vs. 16%, P = 0.0001). On multivariate analysis, the presence of collaterals was a strong predictor of the combined endpoint of death, recurrent MI, CABG, PCI, stroke and CHF (HR 1.95, CI 95% 1.08-3.52; P = 0.027). Similarly, in the subset of 115 patients (43%) in whom the culprit artery was identified, the presence of collaterals was a strong negative predictor (HR 3.71, CI 1.31-10.57, P = 0.014), driven by a 13-fold increase in subsequent CABG.RESULTSAt one year, individuals with collaterals had significantly increased rates of the combined endpoint compared with those without (25% vs. 16%, P = 0.0001). On multivariate analysis, the presence of collaterals was a strong predictor of the combined endpoint of death, recurrent MI, CABG, PCI, stroke and CHF (HR 1.95, CI 95% 1.08-3.52; P = 0.027). Similarly, in the subset of 115 patients (43%) in whom the culprit artery was identified, the presence of collaterals was a strong negative predictor (HR 3.71, CI 1.31-10.57, P = 0.014), driven by a 13-fold increase in subsequent CABG.In patients with NSTEMI the presence of angiographic coronary collaterals is a predictor of long-term clinical outcomes primarily driven by increased rates of surgical revascularization.CONCLUSIONSIn patients with NSTEMI the presence of angiographic coronary collaterals is a predictor of long-term clinical outcomes primarily driven by increased rates of surgical revascularization. Objectives To determine whether the presence of angiographic coronary collaterals is a predictor of long-term clinical outcomes in patients with non-ST elevation myocardial infarction (NSTEMI). Background The presence of coronary collaterals on angiography provides prognostic information in patients with STEMI, but it is unknown whether they provide prognostic information in patients with NSTEMI. Methods This was a prospective cohort study of 931 consecutive patients undergoing coronary angiography of which 269 (29%) had a NSTEMI. Baseline characteristics, angiographic details, and long-term clinical outcomes including death, recurrent MI, coronary artery bypass graft surgery (CABG), percutaneous coronary intervention (PCI), stroke, and congestive heart failure (CHF) were collected. Each clinical outcome as well as the combined endpoint of death, recurrent MI, CABG, PCI stroke and CHF was compared in subjects with and without collaterals. Results At one year, individuals with collaterals had significantly increased rates of the combined endpoint compared with those without (25% vs. 16%, P=0.0001). On multivariate analysis, the presence of collaterals was a strong predictor of the combined endpoint of death, recurrent MI, CABG, PCI, stroke and CHF (HR 1.95, CI 95% 1.08-3.52; P = 0.027). Similarly, in the subset of 115 patients (43%) in whom the culprit artery was identified, the presence of collaterals was a strong negative predictor (HR 3.71, CI 1.31-10.57, P = 0.014), driven by a 13-fold increase in subsequent CABG. Conclusions In patients with NSTEMI the presence of angiographic coronary collaterals is a predictor of long-term clinical outcomes primarily driven by increased rates of surgical revascularization. © 2013 Wiley Periodicals, Inc. [PUBLICATION ABSTRACT] To determine whether the presence of angiographic coronary collaterals is a predictor of long-term clinical outcomes in patients with non-ST elevation myocardial infarction (NSTEMI). The presence of coronary collaterals on angiography provides prognostic information in patients with STEMI, but it is unknown whether they provide prognostic information in patients with NSTEMI. This was a prospective cohort study of 931 consecutive patients undergoing coronary angiography of which 269 (29%) had a NSTEMI. Baseline characteristics, angiographic details, and long-term clinical outcomes including death, recurrent MI, coronary artery bypass graft surgery (CABG), percutaneous coronary intervention (PCI), stroke, and congestive heart failure (CHF) were collected. Each clinical outcome as well as the combined endpoint of death, recurrent MI, CABG, PCI stroke and CHF was compared in subjects with and without collaterals. At one year, individuals with collaterals had significantly increased rates of the combined endpoint compared with those without (25% vs. 16%, P = 0.0001). On multivariate analysis, the presence of collaterals was a strong predictor of the combined endpoint of death, recurrent MI, CABG, PCI, stroke and CHF (HR 1.95, CI 95% 1.08-3.52; P = 0.027). Similarly, in the subset of 115 patients (43%) in whom the culprit artery was identified, the presence of collaterals was a strong negative predictor (HR 3.71, CI 1.31-10.57, P = 0.014), driven by a 13-fold increase in subsequent CABG. In patients with NSTEMI the presence of angiographic coronary collaterals is a predictor of long-term clinical outcomes primarily driven by increased rates of surgical revascularization. |
| Author | Keeley, Ellen C. Lipson, Lewis C. Kloepfer, Angela M. |
| AuthorAffiliation | 1 Department of Medicine, University of Virginia, Charlottesville, Virginia 2 Division of Cardiology, University of Virginia, Charlottesville, Virginia |
| AuthorAffiliation_xml | – name: 2 Division of Cardiology, University of Virginia, Charlottesville, Virginia – name: 1 Department of Medicine, University of Virginia, Charlottesville, Virginia |
| Author_xml | – sequence: 1 givenname: Angela M. surname: Kloepfer fullname: Kloepfer, Angela M. organization: Department of Medicine, University of Virginia, Virginia, Charlottesville – sequence: 2 givenname: Lewis C. surname: Lipson fullname: Lipson, Lewis C. organization: Department of Medicine, University of Virginia, Charlottesville, Virginia – sequence: 3 givenname: Ellen C. surname: Keeley fullname: Keeley, Ellen C. email: keeley@virginia.edu organization: Department of Medicine, University of Virginia, Charlottesville, Virginia |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/23703721$$D View this record in MEDLINE/PubMed |
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To determine whether the presence of angiographic coronary collaterals is a predictor of long‐term clinical outcomes in patients with non‐ST... To determine whether the presence of angiographic coronary collaterals is a predictor of long-term clinical outcomes in patients with non-ST elevation... Objectives To determine whether the presence of angiographic coronary collaterals is a predictor of long-term clinical outcomes in patients with non-ST... |
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| SubjectTerms | Aged Chi-Square Distribution Collateral Circulation Coronary Angiography Coronary Artery Bypass Coronary Circulation coronary collaterals Coronary Vessels - diagnostic imaging Coronary Vessels - physiopathology Female Humans Kaplan-Meier Estimate Male Middle Aged Multivariate Analysis Myocardial Infarction - diagnostic imaging Myocardial Infarction - mortality Myocardial Infarction - physiopathology Myocardial Infarction - therapy non-ST elevation myocardial infarction Percutaneous Coronary Intervention Predictive Value of Tests Prospective Studies Recurrence Registries Risk Factors Time Factors Treatment Outcome |
| Title | The Presence of angiographic collaterals in Non-ST elevation myocardial infarction is a predictor of long-term clinical outcomes |
| URI | https://api.istex.fr/ark:/67375/WNG-MJL2M972-Z/fulltext.pdf https://onlinelibrary.wiley.com/doi/abs/10.1002%2Fccd.25021 https://www.ncbi.nlm.nih.gov/pubmed/23703721 https://www.proquest.com/docview/1468852108 https://www.proquest.com/docview/1469641324 https://pubmed.ncbi.nlm.nih.gov/PMC3858448 |
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