ASSESSMENT OF CORONARY COLLATERAL CIRCULATION PREDICTORS AMONG PATIENTS WITH ACUTE CORONARY SYNDROME IN POPULATION GEORGIA.

ABSTRACT

Coronary collateral circulation (CCC) has been shown to have a prognostic role in acute myocardial infarction (MI). We aimed to identify factors associated with CCC development in patients with acute myocardial ischemia. In the present analysis, 673 consecutive patients aged 27 - 94 years (64.7±11.48) with acute coronary syndrome (ACS), who underwent coronary angiography within the first 24 hours after symptom onset were included. Baseline data, including sex, age, cardiovascular risk factors, medication, antecedent angina, prior coronary revascularization, EF%, blood pressure levels were obtained from patient medical records. The study individuals were divided into two groups patients with Rentrop grade 0 to 1 were classified as the poor collateral group (456 patients), and the patients with grade 2 to 3 - as the good collateral group (217 patients). Prevalence of good collaterals of 32% was found. Odds of good collateral circulation increases with higher eosinophil count - OR=17.36 (95% CI 3.25-92.86); history of MI (OR=1.76; 95% CI1.13-2.75); multivessel disease - OR=9.78 (95% CI 5.65-16.96); culprit vessel stenosis - OR=3.91 (95% CI 2.35-6.52); presence of angina pectoris > 5 years - OR=5.55 (95% CI2.66-11.57) and decreases with high N/L- OR=0.37 (95% CI0.31-0.45) and male gender - OR=0.44 (95% CI0.29-0.67). High N/L is a predictor of poor collateral circulation, with 68.4 sensitivity and 72.8% specificity (cutoff 2.73*109). Relative chance of good collateral circulation increases with the higher number of eosinophils, presence of angina pectoris with duration of more than 5 years, history of past myocardial infarction, culprit vessel stenosis, multivessel disease, and reduces if patient is male and has high N/L ratio. Peripheral blood parameters may serve as an additional simple risk assessment tool in ACS patients.