Does claudication affect the development of coronary collaterals?


ÖZDEMİR Ö., Geyik B., Tosun Ö., Soylu M., DEMİR A. D. , Alyan Ö., ...More

Heart and Vessels, vol.19, no.3, pp.116-120, 2004 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 19 Issue: 3
  • Publication Date: 2004
  • Doi Number: 10.1007/s00380-003-0752-6
  • Journal Name: Heart and Vessels
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.116-120
  • Keywords: claudication, collateral, peripheral arterial disease, atherosclerosis, PERIPHERAL ARTERIAL-DISEASE, RISK-FACTORS, INTERMITTENT CLAUDICATION, MORTALITY, ANGIOGENESIS, SCIENCE
  • Lokman Hekim University Affiliated: Yes

Abstract

Atherothrombosis is a generalized disease process that affects large- and medium-diameter arteries throughout the arterial tree. In this study, we aimed to evaluate the correlation between collaterals in different vascular beds. Patients who had undergone digital subtraction angiography for symptomatic lower extremity peripheral arterial disease and coronary angiography after an acute anterior myocardial infarction (MI) were compared with a control group composed of those patients who were hospitalized for acute anterior MI and underwent coronary angiography but had no claudication and had an ankle-brachial index of greater than 0.9 in both legs. In claudicants, stenosis in the left anterior descending artery (LAD) (90.3 ± 17.5 vs 78.6 ± 13.8, P = 0.005) was greater compared with the patients without claudication. The collaterals to the LAD (88% vs 37.5%, P = 0.001) and the collateral grades (1.7 ± 0.7 vs 0.7 ± 0.9, P = 0.001) were higher in the patients with claudication compared with those without claudication. A previous history of angina (52.2% vs 16.3%, P = 0.001), claudication (39.1% vs 4.6%, P = 0.001), and peripheral collaterals (45.7% vs 6.9%, P = 0.001) were higher in the patients with coronary collaterals than in those without. The factors affecting the development of coronary collaterals were claudication [relative risk (RR): 8.8; 95% confidence interval (CI): 2.1-39.8], peripheral collaterals (RR: 1.1; 95% CI: 1.1-1.3), and LAD stenosis (RR: 1.2; 95% CI: 0.03-29.1). Our results suggest that the presence of collateralization or angiogenesis in one vascular bed highly predicts collateralization in another arterial bed. © Springer-Verlag 2004.