Coronary collaterals and risk for restenosis after percutaneous coronary interventions: a meta-analysis

BMC Medicine

Christian Seiler³  Alexandra J Lansky⁴  Guido Knapp⁵  Tom Crake⁷  Stefano F de Marchi¹  Tobias Traupe³  Bertram Pitt⁶  Andreas Indermuehle²  Pascal Meier⁷ 

[1] University of Oslo, Department of Cardiology, Oslo, Norway;St Thomas' Hospital, Department of Cardiology, King's College London, UK;University Hospital Bern, Department of Cardiology, Bern, Switzerland;Yale University Medical Center, Department of Cardiology, New Haven, CT, USA;TU University Dortmund, Department of Statistics, Dortmund, Germany;University of Michigan Medical Center, Department of Cardiology, Ann Arbor, MI, USA;The Heart Hospital London, University College London Hospital Trust, London, UK

关键词: therapy failure;    restenosis;    meta-analysis;    coronary collateral circulation;   

Others  :  1126071
DOI  :  10.1186/1741-7015-10-62

 received in 2011-08-17, accepted in 2012-06-21,  发布年份 2012

【 摘 要 】

Background

The benefit of the coronary collateral circulation (natural bypass network) on survival is well established. However, data derived from smaller studies indicates that coronary collaterals may increase the risk for restenosis after percutaneous coronary interventions. The purpose of this systematic review and meta-analysis of observational studies was to explore the impact of the collateral circulation on the risk for restenosis.

Methods

We searched the MEDLINE, EMBASE and ISI Web of Science databases (2001 to 15 July 2011). Random effects models were used to calculate summary risk ratios (RR) for restenosis. The primary endpoint was angiographic restenosis > 50%.

Results

A total of 7 studies enrolling 1,425 subjects were integrated in this analysis. On average across studies, the presence of a good collateralization was predictive for restenosis (risk ratio (RR) 1.40 (95% CI 1.09 to 1.80); P = 0.009). This risk ratio was consistent in the subgroup analyses where collateralization was assessed with intracoronary pressure measurements (RR 1.37 (95% CI 1.03 to 1.83); P = 0.038) versus visual assessment (RR 1.41 (95% CI 1.00 to 1.99); P = 0.049). For the subgroup of patients with stable coronary artery disease (CAD), the RR for restenosis with 'good collaterals' was 1.64 (95% CI 1.14 to 2.35) compared to 'poor collaterals' (P = 0.008). For patients with acute myocardial infarction, however, the RR for restenosis with 'good collateralization' was only 1.23 (95% CI 0.89 to 1.69); P = 0.212.

Conclusions

The risk of restenosis after percutaneous coronary intervention (PCI) is increased in patients with good coronary collateralization. Assessment of the coronary collateral circulation before PCI may be useful for risk stratification and for the choice of antiproliferative measures (drug-eluting stent instead bare-metal stent, cilostazol).

【 授权许可】

   
2012 Meier et al; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Seiler C: The human coronary collateral circulation. Eur J Clin Invest 40:465-476.
• [2]Pitt B: Interarterial coronary anastomoses. Occurrence in normal hearts and in certain pathologic conditions. Circulation 1959, 20:816-822.
• [3]Meier P, Gloekler S, Zbinden R, Beckh S, de Marchi SF, Zbinden S, Wustmann K, Billinger M, Vogel R, Cook S, Wenaweser P, Togni M, Windecker S, Meier B, Seiler C: Beneficial effect of recruitable collaterals: a 10-year follow-up study in patients with stable coronary artery disease undergoing quantitative collateral measurements. Circulation 2007, 116:975-983.
• [4]Meier P, Hemingway H, Lansky AJ, Knapp G, Pitt B, Seiler C: The impact of the coronary collateral circulation on mortality: a meta-analysis. Eur Heart J 2012, 33:614-621.
• [5]Jensen LO, Thayssen P, Lassen JF, Hansen HS, Kelbaek H, Junker A, Pedersen KE, Hansen KN, Krusell LR, Botker HE, Thuesen L: Recruitable collateral blood flow index predicts coronary instent restenosis after percutaneous coronary intervention. Eur Heart J 2007, 28:1820-1826.
• [6]Lee CW, Hong MK, Choi SW, Kim JH, Kim JJ, Park SW, Park SJ: Influence of coronary collateral flow on restenosis following primary angioplasty for acute myocardial infarction. Catheter Cardiovasc Interv 2002, 55:477-481.
• [7]Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, Moher D, Becker BJ, Sipe TA, Thacker SB: Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA 2000, 283:2008-2012.
• [8]Wells GA, Brodsky LO, O'Connell D, Shea B, Henry D, Mayank S, Tugwell P: An evaluation of the Newcastle Ottawa scale: an assessment tool for evaluating the quality of non-randomized studies (abstract). In XI International Cochrane Colloquium Book of Abstracts, O-63. Presented at the XI Cochrane Colloquium, Barcelona; 2003:26.
• [9]Juni P, Witschi A, Bloch R, Egger M: The hazards of scoring the quality of clinical trials for meta-analysis. JAMA 1999, 282:1054-1060.
• [10]Gould KL, Lipscomb K, Hamilton GW: Physiologic basis for assessing critical coronary stenosis. Instantaneous flow response and regional distribution during coronary hyperemia as measures of coronary flow reserve. Am J Cardiol 1974, 33:87-94.
• [11]Rentrop KP, Cohen M, Blanke H, Phillips RA: Changes in collateral channel filling immediately after controlled coronary artery occlusion by an angioplasty balloon in human subjects. J Am Coll Cardiol 1985, 5:587-592.
• [12]Seiler C, Fleisch M, Garachemani A, Meier B: Coronary collateral quantitation in patients with coronary artery disease using intravascular flow velocity or pressure measurements. J Am Coll Cardiol 1998, 32:1272-1279.
• [13]DerSimonian R, Laird N: Meta-analysis in clinical trials. Control Clin Trials 1986, 7:177-188.
• [14]Higgins JP, Thompson SG, Spiegelhalter DJ: A re-evaluation of random-effects meta-analysis. J R Stat Soc Ser A Stat Soc 2009, 172:137-159.
• [15]Sankey S, Weissfeld L, Fine M, Kapoor W: An assesment of the use of of the continuity correction for sparse data in metanalysis. Commun Stat B-Simul 1996, 25:1031-1056.
• [16]Higgins JP, Thompson SG: Quantifying heterogeneity in a meta-analysis. Stat Med 2002, 21:1539-1558.
• [17]Begg C, Mazumdar M: Operating characteristics of a rank correlation test for publication bias. Biometrics 1994, 50:1088-1101.
• [18]Egger M, Davey Smith G, Schneider M, Minder C: Bias in meta-analysis detected by a simple, graphical test. BMJ 1997, 315:629-634.
• [19]R Development Core Team: R: A language and environment for statistical computing. [http://www.R-project.org] webcite
• [20]Antoniucci D, Valenti R, Moschi G, Migliorini A, Trapani M, Santoro GM, Bolognese L, Cerisano G, Buonamici P, Dovellini EV: Relation between preintervention angiographic evidence of coronary collateral circulation and clinical and angiographic outcomes after primary angioplasty or stenting for acute myocardial infarction. Am J Cardiol 2002, 89:121-125.
• [21]Probst P, Baumgartner C, Gottsauner-Wolf M: The influence of the presence of collaterals on restenoses after PTCA. Clin Cardiol 1991, 14:803-807.
• [22]Nakae I, Fujita M, Fudo T, Iwase T, Tanaka T, Tamaki S, Nohara R, Sasayama S: Relation between preexistent coronary collateral circulation and the incidence of restenosis after successful primary coronary angioplasty for acute myocardial infarction. J Am Coll Cardiol 1996, 27:1688-1692.
• [23]Wahl A, Billinger M, Fleisch M, Meier B, Seiler C: Quantitatively assessed coronary collaterals and restenosis following percutaneous revascularization. Eur Heart J 1998, 19(Suppl):389.
• [24]Perera D, Postema P, Rashid R, Patel S, Blows L, Marber M, Redwood S: Does a well developed collateral circulation predispose to restenosis after percutaneous coronary intervention? An intravascular ultrasound study. Heart 2006, 92:763-767.
• [25]Wahl A, Billinger M, Fleisch M, Meier B, Seiler C: Quantitatively assessed coronary collateral circulation and restenosis following percutaneous revascularization. Eur Heart J 2000, 21:1776-1784.
• [26]de Marchi SF, Oswald P, Windecker S, Meier B, Seiler C: Reciprocal relationship between left ventricular filling pressure and the recruitable human coronary collateral circulation. Eur Heart J 2005, 26:558-566.
• [27]Tamhane U, Meier P, Chetcuti S, Chen KY, Rha SW, Grossman MP, Gurm H: Efficacy of cilostazol in reducing restenosis in patients undergoing contemporary stent based PCI: a meta-analysis of randomised controlled trials. EuroIntervention 2009, 5:384-393.
• [28]Stettler C, Allemann S, Wandel S, Kastrati A, Morice MC, Schömig A, Pfisterer ME, Stone GW, Leon MB, de Lezo JS, Goy JJ, Park SJ, Sabaté M, Suttorp MJ, Kelbaek H, Spaulding C, Menichelli M, Vermeersch P, Dirksen MT, Cervinka P, De Carlo M, Erglis A, Chechi T, Ortolani P, Schalij MJ, Diem P, Meier B, Windecker S, Jüni P: Drug eluting and bare metal stents in people with and without diabetes: collaborative network meta-analysis. BMJ 2008, 337:a1331.
• [29]Meier P, Gloekler S, de Marchi SF, Zbinden R, Delacretaz E, Seiler C: An indicator of sudden cardiac death during brief coronary occlusion: electrocardiogram QT time and the role of collaterals. Eur Heart J 2010, 31:1197-1204.
• [30]Hlatky MA, Boothroyd DB, Bravata DM, Boersma E, Booth J, Brooks MM, Carrié D, Clayton TC, Danchin N, Flather M, Hamm CW, Hueb WA, Kähler J, Kelsey SF, King SB, Kosinski AS, Lopes N, McDonald KM, Rodriguez A, Serruys P, Sigwart U, Stables RH, Owens DK, Pocock SJ: Coronary artery bypass surgery compared with percutaneous coronary interventions for multivessel disease: a collaborative analysis of individual patient data from ten randomised trials. Lancet 2009, 373:1190-1197.
• [31]Aldridge HE, Trimble AS: Progression of proximal coronary artery lesions to total occlusion after aorta-coronary saphenous vein bypass grafting. J Thorac Cardiovasc Surg 1971, 62:7-11.
• [32]Cashin WL, Sanmarco ME, Nessim SA, Blankenhorn DH: Accelerated progression of atherosclerosis in coronary vessels with minimal lesions that are bypassed. N Engl J Med 1984, 311:824-828.
• [33]Stone PH, Coskun AU, Kinlay S, Clark ME, Sonka M, Wahle A, Ilegbusi OJ, Yeghiazarians Y, Popma JJ, Orav J, Kuntz RE, Feldman CL: Effect of endothelial shear stress on the progression of coronary artery disease, vascular remodeling, and in-stent restenosis in humans: in vivo 6-month follow-up study. Circulation 2003, 108:438-444.
• [34]Fan L, Karino T: Effect of a disturbed flow on proliferation of the cells of a hybrid vascular graft. Biorheology 47:31-38.
• [35]Pan S: Molecular mechanisms responsible for the atheroprotective effects of laminar shear stress. Antioxid Redox Signal 2009, 11:1669-1682.
• [36]Dekker RJ, van Soest S, Fontijn RD, Salamanca S, de Groot PG, VanBavel E, Pannekoek H, Horrevoets AJ: Prolonged fluid shear stress induces a distinct set of endothelial cell genes, most specifically lung Kruppel-like factor (KLF2). Blood 2002, 100:1689-1698.
• [37]Parmar KM, Larman HB, Dai G, Zhang Y, Wang ET, Moorthy SN, Kratz JR, Lin Z, Jain MK, Gimbrone MA Jr, García-Cardeña G: Integration of flow-dependent endothelial phenotypes by Kruppel-like factor 2. J Clin Invest 2006, 116:49-58.
• [38]Dekker RJ, van Thienen JV, Rohlena J, de Jager SC, Elderkamp YW, Seppen J, de Vries CJ, Biessen EA, van Berkel TJ, Pannekoek H, Horrevoets AJ: Endothelial KLF2 links local arterial shear stress levels to the expression of vascular tone-regulating genes. Am J Pathol 2005, 167:609-618.
• [39]Traub O, Berk BC: Laminar shear stress: mechanisms by which endothelial cells transduce an atheroprotective force. Arterioscler Thromb Vasc Biol 1998, 18:677-685.
• [40]Pohl T, Seiler C, Billinger M, Herren E, Wustmann K, Mehta H, Windecker S, Eberli FR, Meier B: Frequency distribution of collateral flow and factors influencing collateral channel development. Functional collateral channel measurement in 450 patients with coronary artery disease. J Am Coll Cardiol 2001, 38:1872-1878.
• [41]Schaper W: Collateral circulation: past and present. Basic Res Cardiol 2009, 104:5-21.
• [42]Wen S, Mao J, Guo L: Multivariate analysis of clinical factors in restenosis after coronary interventional treatment [in Chinese]. Zhonghua Yi Xue Za Zhi 1999, 79:197-199.
• [43]Pinto DS, Stone GW, Ellis SG, Cox DA, Hermiller J, O'Shaughnessy C, Mann JT, Mehran R, Na Y, Turco M, Caputo R, Popma JJ, Cutlip DE, Russell ME, Cohen DJ, TAXUS-IV Investigators: Impact of routine angiographic follow-up on the clinical benefits of paclitaxel-eluting stents: results from the TAXUS-IV trial. J Am Coll Cardiol 2006, 48:32-36.
• [44]Perera D, Kanaganayagam GS, Saha M, Rashid R, Marber MS, Redwood SR: Coronary collaterals remain recruitable after percutaneous intervention. Circulation 2007, 115:2015-2021.
• [45]Farooq V, Gogas BD, Serruys PW: Restenosis: delineating the numerous causes of drug-eluting stent restenosis. Circ Cardiovasc Interv 4:195-205.
• [46]Serruys PW, de Jaegere P, Kiemeneij F, Macaya C, Rutsch W, Heyndrickx G, Emanuelsson H, Marco J, Legrand V, Materne P, Belardi J, Sigwart U, Colombo A, Goy JJ, van den Heuvel P, Delcan J, Morel M-a, Benestent Study Group: A comparison of balloon-expandable-stent implantation with balloon angioplasty in patients with coronary artery disease. Benestent Study Group. N Engl J Med 1994, 331:489-495.