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Novel acute collateral flow index in patients with total coronary artery occlusion during ST-elevation myocardial

Simcha R Meisel1, Michael Shochat, Aaron Frimerman

  • 1Heart Institute, Hillel Yaffe Medical Center, Hadera, Israel. meisel@hy.health.gov.il

Circulation Journal : Official Journal of the Japanese Circulation Society
|December 8, 2011
PubMed

Insights

The new acute collateral flow index (ACFI) effectively measures collateral function in ST-elevation myocardial infarction (STEMI) patients. While collaterals may slightly reduce damage, they do not impact long-term outcomes.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Myocardial Infarction Research

Background:

  • The role of collateral circulation in ST-elevation myocardial infarction (STEMI) remains incompletely understood.
  • Conventional methods for assessing collateral flow index in STEMI are limited, necessitating new approaches.
  • Left ventricular mean diastolic pressure (LVMDP) is a key factor influencing collateral flow in STEMI.

Purpose of the Study:

  • To evaluate the efficacy of a novel LVMDP-based acute collateral flow index (ACFI) for assessing collateral function during STEMI.
  • To compare ACFI with existing measures and clinical outcomes in STEMI patients.

Main Methods:

  • The study involved 111 consecutive STEMI patients undergoing coronary intervention.
  • Pressure distal to occlusion (P(d)) was measured, and ACFI was calculated.
  • Patients were followed for 58 months to assess clinical outcomes.

Main Results:

  • ACFI demonstrated a significant correlation with P(d) and collateral grade (P<0.0001).
  • Lower ACFI tertiles were associated with higher creatine kinase and white cell counts.
  • ACFI showed a slight correlation with early regional ejection fraction but not global function or long-term events.

Conclusions:

  • The ACFI is a suitable tool for evaluating collateral function in the acute phase of STEMI.
  • Collateral flow during STEMI may offer minor protection against myocardial damage.
  • Collateral function did not significantly influence left ventricular contraction or long-term mortality in this cohort.
Abstract

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