Prognosis In Patients Subjected To Chronic Total Occlusion Of Left Anterior Descending Branch With Different Degree Of Collateral Circulation After Revascularization

BackgroundChronic total occlusion(CTO)has a high incidence in coronary heart disease,which is a hot and difficult point in percutaneous coronary intervention(PCI).Although there are still some different sounds,CTO-PCI therapy to improve the symptoms of angina pectoris,improve left ventricular function,stabilize myocardial electrical activity and long-term efficacy have been supported by most large-scale observation and retrospective studies.The formation of collateral circulation is more common in CTO lesions,which plays a role in blood supply instead of occlusive vessels,which is helpful to reduce myocardial necrosis.Due to individual differences,the degree of development of collateral circulation is often inconsistent,whether it is related to the prognosis of patients,related research is still lacking.On the basis of previous studies,the purpose of this study was to observe the prognosis of PCI in patients with chronic occlusive disease of left anterior descending branch(LAD-CTO)with different degree of collateral circulation,and to explore the effect of different degree of collateral circulation on the prognosis of revascularization in LAD-CTO.Objective:To evaluate the effect of different degree of collateral circulation on the prognosis of revascularization in patients with LAD-CTO disease.Methods:From January 2018 to June 2018,a total of 214 patients with LAD-CTO lesions confirmed by coronary angiography(coronary angiography,CAG)in the Department of Cardiology of the first affiliated Hospital of Zhengzhou University were collected.91 patients were excluded from conservative drug treatment,failure of revascularization and loss.Finally,123 patients were included in the study.According to the degree of collateral circulation formation,according to the Rentrop classification standard.Patients with grade 0-1 of Rentrop were included in poor collateral circulation group(n=45),and patients with grade Rentrop2-3 were included in group with good collateral circulation(n=78).The admission and follow-up data were collected,such as current history,past history,family history,serological examination such as N-terminal-pro-B-type natriuretic peptide(NTproBNP),cardiac troponin I(CTNI),high sensitive C reaction protein(hsCRP),left ventricular function index,major adverse cardiovascular events(MACE),to analyze whether there is a difference in the improvement of cardiac function and prognosis between the two groups.Results:After a median follow-up of 15 months,it was found that there was no significant difference in MACE between the two groups after revascularization.The indexes of left ventricular function,such as left ventricular ejection fraction(LVEF),left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV)and left ventricular short axis shortening(LVFS),were improved more significantly in the good collateral circulation group than in the poor collateral circulation groupConclusions:In patients with LAD-CTO disease,after active revascularization treatment,the improvement of left ventricular function in patients with good collateral circulation was more obvious than that in patients with poor collateral circulation,and there was no significant difference in prognosis in patients with LAD-CTO disease with different degrees of collateral circulation after revascularization.