PMID- 32930943
OWN - NLM
STAT- MEDLINE
DCOM- 20220209
LR  - 20220209
IS  - 1573-742X (Electronic)
IS  - 0929-5305 (Linking)
VI  - 51
IP  - 4
DP  - 2021 May
TI  - Prognostic implications of the rapid recruitment of coronary collaterals during 
      ST elevation myocardial infarction (STEMI): a meta-analysis of over 14,000 
      patients.
PG  - 1005-1016
LID - 10.1007/s11239-020-02282-6 [doi]
AB  - Acute coronary collateralisation of an infarct-related arterial (IRA) territory 
      may be identified during angiography for ST elevation myocardial infarction 
      (STEMI). Whether the presence or absence of these collaterals affects outcomes 
      remains uncertain. A search of EMBASE, MEDLINE and Cochrane Library, using the 
      Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) 
      guidelines was conducted to identify studies which reported on the association 
      between coronary collaterals and in-hospital and longer term mortality, left 
      ventricular ejection fraction (LVEF), risk of repeat acute myocardial infarction 
      (AMI) and repeat revascularisation. Patients with Rentrop grade 0 or 1 were 
      defined as poor collaterals whilst those with Rentrop grade two or three were 
      defined as those with robust collaterals. Studies were eligible if they included 
      patients >/= 18 years of age who had immediate coronary angiography for STEMI. 
      Included studies were observational which recorded the degree of collateral blood 
      flow to the IRA. Two investigators reviewed all citations using a predefined 
      protocol with final consensus for all studies, the data from which was then 
      independently entered to ensure fidelity of results. Inverse variance random 
      effects model for the meta-analysis along with risk of bias assessment was 
      performed. 20 studies with a total of 14,608 patients were identified and 
      included in the analysis. Patients with robust collaterals had lower mortality 
      (OR 0.55, 95% CI 0.48-0.64), both in-hospital (OR 0.47, 95% CI 0.35-0.63) and 
      longer term (OR 0.58, 95% CI 0.46-0.75). Patients with robust collaterals also 
      had a higher mean LVEF (SMD 0.23, 95% CI 0.10-0.37). There was no difference in 
      the rates of AMI or repeat revascularisation between patients with robust or poor 
      collaterals. The presence of robust collaterals during STEMI is associated with 
      reduced in-hospital and longer term mortality and improved left ventricular 
      function. These findings have implications for prognostication and identifying 
      patients who require close monitoring following STEMI.
FAU - Allahwala, Usaid K
AU  - Allahwala UK
AUID- ORCID: 0000-0001-7178-4744
AD  - Department of Cardiology, Royal North Shore Hospital, Reserve Rd, St. Leonards, 
      Sydney, 2065, Australia. usaid.allahwala@sydney.edu.au.
AD  - The University of Sydney, Sydney, Australia. usaid.allahwala@sydney.edu.au.
FAU - Nour, Daniel
AU  - Nour D
AD  - Department of Cardiology, Royal North Shore Hospital, Reserve Rd, St. Leonards, 
      Sydney, 2065, Australia.
FAU - Alsanjari, Osama
AU  - Alsanjari O
AD  - Sussex Cardiac Centre, Brighton and Sussex University Hospitals, Brighton, UK.
FAU - Bhatia, Kunwardeep
AU  - Bhatia K
AD  - Department of Cardiology, Royal North Shore Hospital, Reserve Rd, St. Leonards, 
      Sydney, 2065, Australia.
FAU - Nagaraja, Vinayak
AU  - Nagaraja V
AD  - Division of Interventional Cardiology, Cleveland Clinic, Cleveland, OH, USA.
FAU - Khatri, Jaikirshan J
AU  - Khatri JJ
AD  - Division of Interventional Cardiology, Cleveland Clinic, Cleveland, OH, USA.
FAU - Cockburn, James
AU  - Cockburn J
AD  - Sussex Cardiac Centre, Brighton and Sussex University Hospitals, Brighton, UK.
FAU - Hildick-Smith, David
AU  - Hildick-Smith D
AD  - Sussex Cardiac Centre, Brighton and Sussex University Hospitals, Brighton, UK.
FAU - Sakata, Yasuhiko
AU  - Sakata Y
AD  - Department of Cardiovascular Medicine, Tohoku University Graduate School of 
      Medicine, Sendai, Japan.
FAU - Ward, Michael
AU  - Ward M
AD  - Department of Cardiology, Royal North Shore Hospital, Reserve Rd, St. Leonards, 
      Sydney, 2065, Australia.
FAU - Weaver, James C
AU  - Weaver JC
AD  - The University of Sydney, Sydney, Australia.
AD  - Cardiology Department, Royal Prince Alfred Hospital, Sydney, Australia.
FAU - Bhindi, Ravinay
AU  - Bhindi R
AD  - Department of Cardiology, Royal North Shore Hospital, Reserve Rd, St. Leonards, 
      Sydney, 2065, Australia.
AD  - The University of Sydney, Sydney, Australia.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20200915
PL  - Netherlands
TA  - J Thromb Thrombolysis
JT  - Journal of thrombosis and thrombolysis
JID - 9502018
SB  - IM
MH  - Coronary Angiography
MH  - Coronary Circulation
MH  - Humans
MH  - *Myocardial Infarction
MH  - *Percutaneous Coronary Intervention
MH  - Prognosis
MH  - *ST Elevation Myocardial Infarction
MH  - Stroke Volume
MH  - Ventricular Function, Left
OTO - NOTNLM
OT  - Collateral
OT  - Coronary collaterals
OT  - Rentrop
OT  - STEMI
EDAT- 2020/09/16 06:00
MHDA- 2022/02/10 06:00
CRDT- 2020/09/15 12:15
PHST- 2020/09/11 00:00 [accepted]
PHST- 2020/09/16 06:00 [pubmed]
PHST- 2022/02/10 06:00 [medline]
PHST- 2020/09/15 12:15 [entrez]
AID - 10.1007/s11239-020-02282-6 [pii]
AID - 10.1007/s11239-020-02282-6 [doi]
PST - ppublish
SO  - J Thromb Thrombolysis. 2021 May;51(4):1005-1016. doi: 10.1007/s11239-020-02282-6. 
      Epub 2020 Sep 15.