Impact of coronary collateral circulation on angiographic in-stent restenosis in patients with stable coronary artery disease and chronic total occlusion

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• 作者：Zhen Kun Yang^a ; ¹ ; Ying Shen^a ; ¹ ; Jian Hu^a ; Qi Zhang^a ; Feng Hua Ding^a ; Rui Yan Zhang^a ; Lin Lu^a ; ^b ; Wei Feng Shen^a ; ^b ; ^{rjshenweifeng@126.com}
• 关键词：Coronary collateral circulation ; Chronic total occlusion ; In-stent restenosis ; Percutaneous coronary intervention ; Drug-eluting stent
• 刊名：International Journal of Cardiology
• 出版年：2017
• 出版时间：15 January 2017
• 年：2017
• 卷：227
• 期：Complete
• 页码：485-489
• 全文大小：347 K
• 卷排序：227

文摘

This study aimed to evaluate the relationship between coronary collateralization and in-stent restenosis (ISR) in stable coronary artery disease patients with chronic total occlusion (CTO) after percutaneous coronary intervention (PCI) with drug-eluting stent (DES) implantation.MethodsThe degree of coronary collaterals supplying the distal aspect of a total occlusion from the contra-lateral vessel was graded according to Rentrop classification in 216 patients with stable angina undergoing successful DES based PCI for CTO. Univariable and multivariable logistic regression analyses were performed to assess the potential factors related to angiographic ISR during follow-up.ResultsDespite similar number of diseased coronary arteries, good collateralization (Rentrop score 2 or 3) was more frequently associated with right coronary artery occlusion (60%), whereas poor collaterals (Rentrop score 0 or 1) occurred more often in left anterior descending artery occlusion (40%). Despite similar number of CTO intervened, stent length was longer in patients with good collateralization (59 ± 27 mm vs 47 ± 23 mm, p = 0.001). At mean 18 months, the rate of ISR did not significantly differ between patients with good collateralization and those with poor collateralization (12.7% vs 20.2%, p = 0.148). At multivariable analysis, age (OR 1.058, 95%CI 1.015–1.104, p = 0.008), history of diabetes mellitus (OR 2.382, 95%CI 1.109–5.116, p = 0.026) and reference CTO vessel diameter (OR 0.219, 95% CI 0.051–0.951, p = 0.043) were independent risk factors for ISR while Rentrop collateral grade (OR 0.795, 95% CI 0.365–1.732, p = 0.414) was not associated with ISR.ConclusionsThe occurrence of ISR after successful DES based PCI for CTO may be not influenced by coronary collateralization.