| Objective:To investigate which clinical factors affecting the development of coronary collateral circulation,and to explore the role of GDF-15 in the formation of collateral circulation.Methods:The study included 322 patients who underwent selective coronary angiography in Huashan hospital.According to the angiographic result,the extent of collateral circulation was assessed by Rentrop's grading system,and the severity of coronary lesion was evaluated by Gensini's scoring system.We analyzed the relationship between these clinical factors and the development of collaterals after then.The plasma level of growth differentiation factor-15(GDF-15),soluble fms-like tyrosine kinase-1(sFLT-1),and asymmetric dimethylarginine(ADMA) were measured by ELISA in 201 blood samples from the included population.Correlation between the collateral extent and these cytokines was analyzed after then.Results:A positive correlation with the extent of collateral was found within certain clinical factors:systolic blood pressure,pulse pressure,triglyceride,and lipoprotein (a).However,high sensitivity CRP was found inversely related to the extent of collateral(P＜0.05).The plasma level of sFLT-1 and GDF-15 was significantly related with higher Rentrop's grade(the correlation coefficient was 0.337 and 0.406 respectively),and GDF-15 was positively related to Gensini score(R=0.517, P＜0.001).The plasma level of ADMA was related to poor Rentrop's grade(R=-0.364, P＜0.05).We also found correlation between Rentrop's grade and leukocyte count, neutrocyte count,monocyte count respectively.Conclusions:Factors including systolic blood pressure,pulse pressure,triglyceride, lipoprotein(a),and hsCRP may affect the development of coronary collateral circulation.GDF-15 in some level influences the formation and the development of collateral circulation.Leukocyte count,neutrocyte count,and monocyte count may have a predictive value for the existence of coronary collateral.
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