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Coronary Collateral Flow Predicts Outcomes in STEMI

Extensive collateral networks associated with better survival, fewer adverse events

THURSDAY, Sept. 2 (HealthDay News) -- The extent of coronary collateral flow in ST-elevation myocardial infarction (STEMI) patients prior to mechanical reperfusion may predict their long-term clinical outcomes, according to research published in the Sept. 1 issue of the American Journal of Cardiology.

Steffen Desch, M.D., of the University of Leipzig Heart Center in Germany, and colleagues studied long-term outcomes in 227 STEMI patients undergoing percutaneous coronary intervention to examine the role of pre-reperfusion coronary collateral flow on long-term prognosis.

The researchers found the degree of collateral flow at baseline to be a predictor of long-term outcomes. During the median follow-up of 797 days, 22 (13.8 percent) of the 166 patients with absent or weak collateral flow died compared with three (4.4 percent) of the 69 patients who had significant flow (P = 0.04). In addition, 12 (7.5 percent) of those with absent or weak collateral flow experienced nonfatal recurrent myocardial infarctions, compared with two (2.9 percent) of the patients who had significant flow (P = 0.18). There was a significantly lower event rate for the combined major adverse cardiovascular event end point (death or nonfatal reinfarction) in the group with significant flow.

"In conclusion, the presence of a well-developed collateral network before mechanical reperfusion in patients with STEMI is associated with improved long-term survival and lower major adverse cardiovascular event rates," the authors write.

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