Coronary Collaterals Function and Clinical Outcome Between Patients With Acute and Chronic Total Occlusion

Abstract Objectives This study sought to demonstrate how changes in the collateral function and its clinical significance before and after percutaneous coronary interventions (PCIs) are compared between patients with acute coronary syndrome and total or nearly total occlusions (ATOs) and chronic tot...

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Published in:JACC. Cardiovascular interventions 2017-03, Vol.10 (6), p.585-593
Main Authors: Lee, Jang Hoon, MD, Kim, Chang-Yeon, MD, Kim, Namkyun, MD, Jang, Se Yong, MD, Bae, Myung Hwan, MD, Yang, Dong Heon, MD, Cho, Yongkeun, MD, Chae, Shung Chull, MD, Park, Hun Sik, MD
Format: Article
Language:English
Subjects:
Acute Coronary Syndrome - diagnosis
Acute Coronary Syndrome - physiopathology
Acute Coronary Syndrome - therapy
Adenosine - administration & dosage
Aged
Cardiac Catheterization
Cardiovascular
Chronic Disease
chronic total occlusion
Collateral Circulation
Coronary Occlusion - diagnostic imaging
Coronary Occlusion - physiopathology
Coronary Occlusion - therapy
coronary physiology
Coronary Vessels - diagnostic imaging
Coronary Vessels - physiopathology
Disease-Free Survival
Female
Fractional Flow Reserve, Myocardial
Humans
Hyperemia - physiopathology
Kaplan-Meier Estimate
Male
Middle Aged
Percutaneous Coronary Intervention - adverse effects
prognosis
Risk Factors
Time Factors
Treatment Outcome
Vasodilator Agents - administration & dosage
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Summary:Abstract Objectives This study sought to demonstrate how changes in the collateral function and its clinical significance before and after percutaneous coronary interventions (PCIs) are compared between patients with acute coronary syndrome and total or nearly total occlusions (ATOs) and chronic total occlusions (CTOs). Background The functional relevance of the collateral circulation in patients with ATOs and CTOs has not been fully investigated. Methods The pressure-derived collateral pressure index (CPI), myocardial fractional flow reserve (FFRmyo), and coronary fractional flow reserve (FFRcor) at maximum hyperemia induced by intravenous adenosine were evaluated in occluded vessels at baseline, after the PCI, and at 1 year in 23 ATO and 74 CTO patients. Results The FFRmyo and FFRcor were significantly lower, but the CPI was significantly higher in the CTO than ATO patients at baseline and after the PCI. There were significant increases in the FFRmyo (p < 0.001) and FFRcor (p 
ISSN:1936-8798
1876-7605
DOI:10.1016/j.jcin.2016.12.009