ASSESSMENT OF CORONARY COLLATERAL CIRCULATION PREDICTORS AMONG PATIENTS WITH ACUTE CORONARY SYNDROME IN POPULATION
M Chigogidze1, Z Pagava1, I Taboridze2
11Ivane Javakhishvili Tbilisi State University, Georgia.
Georgian Medical News
|March 3, 2023
Summary
Coronary collateral circulation (CCC) is crucial in acute myocardial infarction. Good CCC is linked to higher eosinophil counts, prior heart attacks, and multivessel disease, while poor CCC is associated with a high neutrophil-to-lymphocyte (N/L) ratio and male gender.
Area of Science:
- Cardiology
- Vascular Biology
- Hematology
Background:
- Coronary collateral circulation (CCC) plays a significant prognostic role in patients experiencing acute myocardial infarction (MI).
- Understanding factors influencing CCC development is essential for managing acute coronary syndrome (ACS).
Purpose of the Study:
- To identify clinical and laboratory factors associated with the development of coronary collateral circulation in patients with acute myocardial ischemia.
- To explore the predictive value of peripheral blood parameters, such as the neutrophil-to-lymphocyte (N/L) ratio and eosinophil count, in assessing collateralization.
Main Methods:
- A cohort of 673 patients with ACS undergoing coronary angiography within 24 hours of symptom onset were analyzed.
- Patients were categorized into poor (Rentrop grade 0-1) and good (Rentrop grade 2-3) collateral circulation groups.
- Baseline data including demographics, cardiovascular risk factors, medical history, and blood parameters were collected and analyzed.
Main Results:
- The prevalence of good collateral circulation was 32%.
- Factors positively associated with good CCC included higher eosinophil count (OR=17.36), history of MI (OR=1.76), multivessel disease (OR=9.78), culprit vessel stenosis (OR=3.91), and long-standing angina (OR=5.55).
- Factors negatively associated with good CCC were high N/L ratio (OR=0.37) and male gender (OR=0.44). A high N/L ratio was a predictor of poor collateralization (68.4% sensitivity, 72.8% specificity).
Conclusions:
- Peripheral blood parameters, particularly eosinophil count and the N/L ratio, may serve as simple, additional tools for risk assessment in ACS patients.
- Clinical factors like history of MI, multivessel disease, and symptom duration significantly influence collateral development.
- Male gender is associated with poorer collateralization in ACS patients.
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