The relationship between coronary collateral circulation and blood high-sensitivity C-reactive protein levels

OBJECTIVES
We evaluated the relationship between coronary collateral circulation (CCC) and blood high-sensitivity C-reactive protein (hs-CRP) levels in patients with chronic stable coronary artery disease.

STUDY DESIGN
The study included 104 patients who underwent coronary angiography at least one month after acute coronary event and were found to have total coronary occlusion in at least one major coronary artery. Patients with the diagnosis of acute coronary syndrome within the past month, severe valve disease, systemic disease, systemic inflammatory disease, or a history of coronary surgery or percutaneous coronary intervention were excluded. Collateral circulation was graded according to the Rentrop classification. Grades 0 and 1 were defined as poor, grades 2 and 3 were defined as good CCC. Blood hs-CRP levels were measured 1 to 7 days before coronary angiography.

RESULTS
According to the Rentrop classification, CCC was graded as 0 in 10 patients, 1 in 26 patients, 2 in 29 patients, and 3 in 39 patients. Sixty-eight patients (65.4%) had a good CCC, and 36 patients (34.6%) had a poor CCC. The two groups were similar with respect to age, sex, risk factors, medications, localization of the occluded coronary artery, and the number of occluded arteries. However, hs-CRP levels were significantly higher in patients with a poor CCC (median 5.42 mg/dl; range 2.3-9.8 mg/dl) compared to those with a good CCC (median 3.36 mg/dl; range 2.2-9.7 mg/dl, p=0.003). Logistic regression analysis showed that hs-CRP level was a significant predictor exerting an adverse effect on collateral development (β=-320; odds ratio= 0.725; 95% confidence interval 0.587-0.894; p=0.003).

CONCLUSION
Our findings suggest that high hs-CRP level is a significant predictor of poor collateral development in patients with chronic stable coronary artery disease.