The prognostic value of collateral circulation in coronary chronic total occlusion underwent percutaneous coronary intervention

作     者：Xiao-Ying HU Wei-Xian YANG Chang-Dong GUAN Li-Hua XIE Ke-Fei DOU Yong-Jian WU Jin-Qing YUAN Jie QIAN Yue-Jin YANG Shu-Bin QIAO Lei SONG Xiao-Ying HU;Wei-Xian YANG;Chang-Dong GUAN;Li-Hua XIE;Ke-Fei DOU;Yong-Jian WU;Jin-Qing YUAN;Jie QIAN;Yue-Jin YANG;Shu-Bin QIAO;Lei SONG

作者机构：Department of CardiologyFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina National Clinical Research Center for Cardiovascular DiseasesBeijingChina Catheterization LaboratoriesFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina 

出 版 物：《Journal of Geriatric Cardiology》 (老年心脏病学杂志（英文版）)

年 卷 期：2024年第21卷第2期

页      面：232-241页

核心收录：

学科分类：1002[医学-临床医学] 10[医学] 

主　　题：coronary collateral occlusion 

摘      要：BACKGROUND The prognostic value of coronary collateral circulation(CC)in patients undergoing chronic total occlusion(CTO)percutaneous coronary intervention(PCI)is underdetermined.The purpose of the study was to assess the prognostic value of current two CC grading systems and their association with long-term outcomes in patients with CTO underwent PCI.METHODS We consecutively enrolled patients with single-vessel CTO underwent PCI between January 2010 and December2013.All patients were categorized into well-developed or poor-developed collaterals group according to angiographic Werner s CC(grade 2 vs.grade 0–1)or Rentrop(grade 3 vs.grade 0–2)grading system.The primary endpoint was 5-year cardiac death.RESULTS Of 2452 enrolled patients,the overall technical success rate was 74.1%.Well-developed collaterals were present in686 patients(28.0%)defined by Werner s CC grade 2,and in 1145 patients(46.7%)by Rentrop grade 3.According to Werner s CC grading system,patients with well-developed collaterals had a lower rate of 5-year cardiac death compared with those with poordeveloped collaterals(1.6%vs.3.3%,P=0.02),those with suboptimal recanalization was associated with higher rate of 5-year cardiac death compared with optimal recanalization(4.7%vs.0.8%,P=0.01)and failure patients(4.7%vs.1.6%,P=0.12).However,the similar effect was not shown in Rentrop grading system.CONCLUSIONS In patients with the single-vessel CTO underwent PCI,well-developed collaterals by Werner s CC definition were associated with lower rate of 5-year cardiac death.Werner s CC grading system had a greater prognostic value than Rentrop grading system in patients with CTO underwent PCI.