Coronary artery disease
Relation of C-Reactive Protein to Coronary Collaterals in Patients With Stable Angina Pectoris and Coronary Artery Disease

https://doi.org/10.1016/j.amjcard.2006.08.062Get rights and content

The heterogeneity in the degree of collateralization among patients with coronary artery disease (CAD) is poorly understood. We sought to determine whether chronic subclinical inflammation is related to coronary collateral development in patients with chronic stable angina pectoris and obstructive CAD. High-sensitivity C-reactive protein (CRP) levels were measured in 177 patients with stable angina pectoris before coronary angiography. Multivariable logistic regression revealed an inverse graded association between CRP and the presence of coronary collaterals (Rentrop grade 1 to 3). Compared with patients in the first CRP tertile, the adjusted odds ratio for the presence of coronary collaterals was 0.70 (95% confidence interval, 0.33 to 1.52; p = 0.45) for patients in the second CRP tertile and 0.33 (95% confidence interval, 0.15 to 0.75; p = 0.008) for patients in the third CRP tertile (p for trend = 0.008). In conclusion, an inverse graded association exists between CRP and the presence of coronary collaterals in patients with stable angina pectoris.

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Methods and Results

The patients included in this study were prospectively selected from a total of 3,021 consecutive patients who were referred for coronary angiography at our institution between November 2004 and April 2006. Inclusion criteria were stable angina pectoris with a stenosis of ≥90% in ≥1 coronary vessel. Exclusion criteria included (1) any known inflammatory, neoplastic or infectious disease, (2) treatment with steroids, immunosuppressive drugs or nonsteroidal anti-inflammatory drugs except for

Discussion

The results of the present prospective study demonstrate a graded inverse independent association between CRP levels and collateral development in patients with chronic stable angina pectoris. These findings are consistent with several recent reports. Seiler et al8 demonstrated that tumor necrosis factor-α was detectable more often in patients with insufficient collaterals compared with those with sufficient collaterals. Guray et al9 reported an association between poor coronary collateral

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