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

Department of Interventional Cardiology, Instituto Cardiovascular de Buenos Aires, Argentina, malbertal{at}fibertel.com.ar

Fernando Cura, MD

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

Alejandro G. Escudero, MD

Department of Interventional Cardiology, Hospital Cosme Argerich Argentina, Argentina

Lucio T. Padilla

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

Jorge Thierer

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

Marcelo Trivi

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

Jorge A Belardi, MD

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

PREMIAR InvestigatorsBelardi

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.

Key Words: collateral circulation • acute myocardial infarction • myocardial reperfusion • myocardial protection

This version was published on October 1, 2008

Angiology, Vol. 59, No. 5, 587-592 (2008)
DOI: 10.1177/0003319707308725


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