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Predictor of poor coronary collaterals in elderly population with significant coronary artery disease

Po-Chao Hsu1, Suh-Hang Juo, Ho-Ming Su

  • 1Division of Cardiology (P-CH, HMS, H-MS, W-CT, W-CV, W-TL, S-HS, T-HL), Department of Internal Medicine and Department of Medical Research (S-HJ), Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Internal Medicine (H-MS, W-CV, W-TL, T-HL), Faculty of Medicine, Graduate Institute of Medicine (P-CH), Medical Genetics (S-HJ), and Center of Excellence for Environmental Medicine (S-HJ, S-HS), Kaohsiung Medical University, Kaohsiung, Taiwan; and Department of Internal Medicine (H-MS), Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan.

The American Journal of the Medical Sciences
|December 11, 2012
PubMed

Insights

Advanced age and diabetes negatively impact coronary collateral circulation in elderly patients. These factors are significant predictors of poor collateral development, increasing cardiovascular risk.

Area of Science:

  • Cardiology
  • Geriatric Medicine
  • Vascular Biology

Background:

  • Coronary collateral circulation is vital for myocardial protection against ischemia.
  • Advanced age may correlate with diminished collateral development and poorer cardiovascular outcomes.
  • Predictors of collateral development in elderly individuals require further investigation.

Purpose of the Study:

  • To identify predictors of coronary collateral development in patients aged 65 and older.
  • To investigate the influence of age and comorbidities on collateral formation in the elderly.

Main Methods:

  • Analysis of 207 elderly patients (≥65 years) undergoing coronary angiography.
  • Utilized the Rentrop collateral scoring system to categorize collateral formation as poor or good.
  • Multivariate analysis to determine significant predictors of poor collateralization.

Main Results:

  • Poor collateral formation was associated with older age, male sex, fewer diseased vessels, and a trend towards diabetes.
  • Age (OR=1.068), diabetes (OR=2.681), and diseased vessel count (OR=0.337) were significant predictors of poor collaterals.
  • A synergistic effect between age and diabetes on poor collateral development was observed (P=0.041).

Conclusions:

  • Age and diabetes mellitus are significant negative predictors of coronary collateral development in the elderly.
  • These factors may impair the heart's protective mechanisms against ischemic events in older adults.
  • Understanding these predictors can inform strategies for managing cardiovascular risk in geriatric populations.
Abstract

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