The Analysis Of The Influencing Factors And Clinical Significance Of Coronary Collateral Circulation In Patients With Chronic Total Occluded (CTO) Coronary Artery Disease

Objective:The development of coronary collateral circulation(CCC) was a complicated process,and was influenced by many factors.The objective of the study was to investigate the significance of coronary collateral circulation in patients with chronic total occluded(CTO) coronary artery disease and factors influencing collateral channel development.Methods:The retrospective study was to assess the relationship between the coronary collateral circulation(CCC) and factors influencing clinical features coronary angiographic characteristics by means of univariate analysis and logistic regression analysis in specimens from patients with CCC group A(n=205) and patients with non-CCC group B(n=111) according to the Cohen and Rentrop's method which are used to score the CCC commonly.The clinical factors such as age,gender,cigarette use,alcohol use,blood pressure,cholesterol,duration of angina pectoris,angiographic characteristics of CTO arteries are concerned.Results:1 The result of CAG revealed that The proximal lesion promotes the development of collaterals of coronary artery.2 Univariate analysis indicated that the level of fasting plasma glucose(FPG) among the CTO patients,was lower in CCC group than non-CCC group(7.65±1.82 vs.10.65±3.86,P＜0.01);Furthermore,logistic regression analysis proved the result with a formula:Y(CCC)=11.341-2.150(FPG)+2.443(duration of the angina)(P=0.001).3 Duration of angina(＞6months) is significantly higher in group A than that in group B.Furthermore,logistic regression analysis proved the result with statistics(P =0.001).4 Electrocardiogram:Both group A and B had extensive ST segment depression,which revealed the possibility of chronic coronary occlusions with multivessel disease.Abnormal Q waves(26.3%vs 64.9%) were less frequently observed in group A than in group B.5 Univariate regression analysis revealed that there was negative correlation between other factors such as gender,age,cigarettes,alcohol,hypertension,the level of serum total cholesterol and CCC development.Conclusions::①The proximal lesions promote the development of collaterals of coronary artery.②Duration of angina(＞6 months) is an important factor for the presence of collateral vascular in chronic coronary occlusions.③There are some points that revealed the possibility of chronic coronary occlusions with multivessel disease.The points conclude permanent history of exertional angina and extensive ST segment depression formed.④The presence of proximal lesion of location and diabetes mellitus was independent predictor of collateral development.The diabetes mellitus restrains the development of collaterals.