| Objective:To investigate the correlation between coronary collateral circulation and the prognosis of patients with acute coronary syndrome after PCI,and the related factors affecting the development of coronary collateral circulation.Methods: A retrospective study of the effect of collateral circulation on the prognosis of patients with acute coronary syndrome.Approved by the Medical Ethics Committee of Loudi Central Hospital,the patients were informed consent.Between October 2015 and February 2017,the study population included 200 consecutive patients with ACS who was admitted to Loudi Central Hospital.By observing the results of the patient's angiography,The CCC to the culprit vessel and/or the nonculprit vessel was graded on baseline angiograms using a four-degree qualitative classification suggested by Rentrop and Cohen as follows: grade 0 showing no filling;grade 1showing filling of side branches through collateral channels without visualization of the epicardial segment;grade 2 showing partial filling of the epicardial major coronaryartery through collateral channels;and grade 3 showing complete filling of the epicardial major coronary artery.In patients with more than one coronary artery lesion,when there was more than one CCC,the CCC with the highest Rentrop grade was used.The two groups of patients were followed up and collected the indexes and clinical manifestations that might affect the prognosis of patients with ACS such as NT-proBNP,TnI,CK-MB,hs-CRP,CI,LVEF,postoperative hospital stay,ventricular aneurysm formation,adverse cardiovascular events,re-admission within 6 months,in-hospital mortality,and death within a year,and general data.The Rentrop0 grade was divided into group A: that is,there was no collateral circulation formation group;Rentrop 1 grade,Rentrop 2 grade and Rentrop 3 grade were divided into group B: that is,there was collateral circulation formation group.Results:1.Comparison between group A(non-collateral circulation group)and group B(collateral circulation group): preonset angina pectoris(35.8% VS 57.4%),smoking(56.6% VS 41.5%),fasting blood glucose(8.33±3.41 VS 7.20±3.54),multivessel disease(28.1% VS 41.5%)were statistically significant difference,p<0.05.The factors such as pre infarction angina,smoking,fasting blood glucose(>6.1mmol/l)and multiple vessel diseases were analyzed by Logistic regression analysis.It was found that preonset angina pectoris was a favorable factor for the formation of collateral circulation(p<0.05),and smoking was an unfavorable factor for the formation of collateral circulation(p<0.05).2.Comparison between group A(non-collateral circulation group)and group B(collateral circulation group): LVEF one years after PCI(52.7±6.78 VS 55.2±7.36),Changes in LVEF values within one year(4.03 ± 2.84% vs 4.83 ± 2.36%),left ventricular end diastolic diameters(42.79 ± 2.42 VS 41.12 ± 2.16 mm),ventricular aneurysm(18.9% VS 6.4%),readmission rate within a year(35.8% VS 18.1%)?MACE events(17.9% VS 6.4%),mortality rate within 1 year(7.5% VS 1.1%)were statistically significant difference,p<0.05.3.In univariate logistic regression analysis,the coefficient of formation of CCC was-1.772(OR: 0.310;95% CI: 0.216-0.585;p<0.05);in multivariate logistic regression analysis,the coefficient of formation of CCC was-0.631(OR: 0.532;95% CI: 0.416-0.785;p<0.05);Multivariate logistic regression analysis showed that the age-?65-year-old coefficient was 0.716(OR: 2.975;95% CI: 2.194-4.146;p<0.05).Conclusions:1.The formation of the coronary collateral circulation can reduce the major adverse cardiovascular events in patients with acute coronary syndrome PCI,and the patients with collateral circulation have a better prognosis than those without collateral circulation.2.Angina pectoris is the main factor affecting the formation of coronary collateral circulation.Smoking is the main factor affecting the formation of no collateral circulation. |
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