Related Experiment Video

Updated: May 28, 2026

Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
10:03

Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty

Published on: January 28, 2020

The impact of the coronary collateral circulation on mortality: a meta-analysis

Pascal Meier1, Harry Hemingway, Alexandra J Lansky

  • 1The Heart Hospital, University College London Hospitals, Cardiology, London, UK.

European Heart Journal
|October 5, 2011
PubMed

Insights

Good coronary collateral circulation significantly reduces all-cause mortality in patients with coronary artery disease (CAD). This finding highlights the protective role of collateral blood supply in cardiovascular health.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Clinical Research

Background:

  • Coronary collateral circulation provides an alternative blood supply, benefiting patients with myocardial infarction (MI) by reducing infarct size and improving left ventricular remodeling.
  • The impact of collateral circulation on hard endpoints like mortality, particularly in stable coronary artery disease (CAD), remains debated.

Purpose of the Study:

  • To systematically review and meta-analyze the existing literature to determine the effect of coronary collateral circulation on all-cause mortality.
  • To clarify the controversial role of collateral circulation in patients with stable CAD and acute/subacute MI.

Main Methods:

  • A comprehensive literature search was conducted across MEDLINE, EMBASE, and ISI Web of Science (2001-2011), including conference proceedings.
  • Random-effect models were employed to calculate summary risk ratios (RR) for mortality based on collateralization levels.
  • Data from 12 studies involving 6529 participants were analyzed.

Main Results:

  • Patients with high coronary collateralization demonstrated significantly reduced all-cause mortality compared to those with low collateralization (RR 0.64; P=0.012).
  • In patients with stable CAD, high collateralization was associated with a 41% reduction in mortality risk (RR 0.59; P=0.012).
  • Subacute and acute MI subgroups showed a trend towards reduced mortality with high collateralization, though not statistically significant in this analysis.

Conclusions:

  • Coronary collateralization exerts a significant protective effect in patients with coronary artery disease (CAD).
  • Individuals with robust collateral circulation experience a 36% lower risk of all-cause mortality compared to those with poor collateralization.
  • These findings underscore the clinical importance of assessing and potentially enhancing coronary collateral function in cardiovascular patient management.
Abstract

More Related Videos

Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control05:41

Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control

Published on: December 16, 2022

Related Concept Videos

Coronary Artery Disease II: Pathophysiology01:26

Coronary Artery Disease II: Pathophysiology

Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
Coronary Artery Disease III: Clinical Manifestations01:30

Coronary Artery Disease III: Clinical Manifestations

Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
Coronary Artery Disease I: Introduction01:30

Coronary Artery Disease I: Introduction

Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...