Relationship Between Collateral Circulation and Successful Myocardial Reperfusion in Acute Myocardial Infarction: A Subanalysis of the PREMIAR Trial

Author:

Albertal Mariano1,Cura Fernando2,Escudero Alejandro G.3,Padilla Lucio T.2,Thierer Jorge2,Trivi Marcelo2,Belardi Jorge A2,PREMIAR InvestigatorsBelardi

Affiliation:

1. Department of Interventional Cardiology, Instituto Cardiovascular de Buenos Aires, Argentina,

2. Department of Interventional Cardiology, Instituto Cardiovascular de Buenos Aires, Argentina

3. Department of Interventional Cardiology, Hospital Cosme Argerich Argentina, Argentina

Abstract

The aim of this study was to determine whether the presence of collateral circulation had a beneficial effect following primary angioplasty. In all, 114 patients who underwent primary angioplasty were included. Patients with collateral circulation had lower basal ST-segment deviation ( P = .004), white cell count ( P = .001), peak creatine kinase ( P = .001), and regional wall motion score values ( P = .03) than patients without collateral circulation. After the procedure, the group with collaterals was associated with higher rates of normal myocardial blush, complete ST resolution, and shorter time to stable ST-recovery. Multivariable logistic analysis identified the presence of collateral circulation as independent predictor of normal myocardial blush (adjusted odds ratio = 3.98, 95% confidence interval, 1.12-14.09; P = .033) and rapid reperfusion (time to stable ST-segment recovery <7 minutes, adjusted odds ratio = 4.0, 95% confidence interval, 1.57-10.20; P = .004). The presence of collateral circulation has a protective effect on infarct size, resulting in faster reperfusion.

Publisher

SAGE Publications

Subject

Cardiology and Cardiovascular Medicine

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