Factors Related To The Formation Of Collateral Circulation In Coronary Arteries And Their Influence On The Prognosis After PCI

Objective:By analyzing the clinical data of patients with coronary atherosclerosis(CHD),the related factors affecting the formation of coronary collateral circulation in CHD patients were discussed,and the effect of coronary collateral circulation(CCC)on the prognosis after PCI was studied.Methods:This study continuous selection jan 2017 to jun 2018 in because of coronary atherosclerotic heart disease at the 1st affiliated hospital of bengbu medical college of cardiology,patients and left circumflex coronary artery DSA suggests a(left circumflex arteries LCX),left anterior descending branch(left anterior item first-just arteries LAD)and right coronary artery(right coronary arteriesFor 630 patients with at least one vascular stenosis degree of 75% in RCA,Rentrop method was used to grade the collateral circulation of coronary arteries.According to the visual grading of coronary angiography,the collateral circulation of coronary arteries was divided into 4 grades: CCC0 was the unformed group of CCC(n=382 cases),and CCC 1-3was the formed group of CCC(n=248 cases).Clinical data of the selected patients were collected retrospectively,such as age,gender,diabetes,hyperlipidemia,smoking history,whether acute myocardial infarction,major postoperative adverse events and complications,etc.To analyze whether the collected clinical data were related factors affecting the formation of CCC.Statistical analysis was conducted on the factors significantly related to the formation of CCC,and the factors affecting the formation of CCC were obtained.The prognosis was divided into 5 types:(1)cardiogenicshock;(2)heart failure;(3)arrhythmia;(4)angina pectoris;(5)hospitalization period.Results:1.A total of 630 patients were enrolled,which were divided into CCC unformedgroup(CCC grade 0)and CCC formed group(CCC grade 1-3).Single factor analysis of clinical data: diabetes,smoking history,nt-probnp were not conducive to the establishment of CCC(P<0.05),and myocardial infarction is conducive to the formation of CCC.2.Severe coronary artery stenosis and right coronary artery lesions were conducive to the establishment of coronary artery collateral circulation,but there was no statistical difference between the two groups in the incidence of multi-vessel lesions and CCC.3.The incidence of arrhythmia and angina after PCI was lower in CCC group than in CCC group(P<0.05).The postoperative hospitalization period was shortened in the CCC group(P<0.05),while there was no significant difference in the incidence of heart failure,cardiogenic shock between the two groups(P<0.05).Conclusion:1.Smoking,diabetes and nt-probnp are not conducive to the formation of collateral circulation in patients with coronary artery sclerosis heart disease,myocardial infarction seems to be more prone to collateral circulation.2.Severe coronary artery stenosis and right coronary artery lesions were conducive to the establishment of coronary artery collateral circulation,but there was no statistical difference between the two groups in the incidence of multi-vessel lesions and CCC.3.Good coronary collateral circulation can reduce the incidence of angina and arrhythmia after PCI,and shorten the postoperative hospital stay;However,there was no significant effect on postoperative heart failure,cardiogenic shock.