The impact of the coronary collateral circulation on mortality: a meta-analysis
The impact of the coronary collateral circulation on mortality: a meta-analysis
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DOI：
10.1093/eurheartj/ehr308
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发表时间：
2012-03-01
影响因子：
39.3
通讯作者：
Seiler, Christian
中科院分区：
文献类型：
--
作者：
Meier, Pascal;Hemingway, Harry;Seiler, Christian
冠状动脉侧支循环作为血液供应的替代来源，已显示出对心肌梗死（MI）患者的几个临床终点（如梗死面积和左心室重塑）的益处。然而，其对死亡率等硬终点的影响及其对稳定性冠状动脉疾病（CAD）患者的影响更具争议。本系统综述和荟萃分析的目的是探讨侧支循环对全因死亡率的影响，我们检索了MEDLINE、EMBASE、ISI Web of Science（2001年至2011年4月25日）和会议记录，以评估冠状动脉侧支循环对死亡率的影响。随机效应模型用于计算汇总风险比（RR）。共有12项研究纳入了6529例受试者。与低侧支化患者相比，高侧支化患者的死亡率降低[RR 0.64（95置信区间0.45 - 0.91）; P 0.012]。稳定型CAD患者的“高支化”RR为0.59 [0.39 ± 0.89]，P 0.012，亚急性MI患者为0.53 [0.15 ± 1.92]; P 0.335，急性MI患者为0.63 [0.29 ± 1.39]; P0.257.冠状动脉侧支化对冠心病患者有保护作用.与低侧支化患者相比，高侧支化患者的死亡风险降低36。
The coronary collateral circulation as an alternative source of blood supply has shown benefits regarding several clinical endpoints in patients with myocardial infarction (MI) such as infarct size and left ventricular remodelling. However, its impact on hard endpoints such as mortality and its impact in patients with stable coronary artery disease (CAD) is more controversial. The purpose of this systematic review and meta-analysis was to explore the impact of collateral circulation on all-cause mortality.We searched MEDLINE, EMBASE, ISI Web of Science (2001 to 25 April 2011), and conference proceedings for studies evaluating the effect of coronary collaterals on mortality. Random-effect models were used to calculate summary risk ratios (RR). A total of 12 studies enrolling 6529 participants were included in this analysis. Patients with high collateralization showed a reduced mortality compared with those with low collateralization [RR 0.64 (95 confidence interval 0.450.91); P 0.012]. The RR for ohigh collateralization' in patients with stable CAD was 0.59 [0.390.89], P 0.012, in patients with subacute MI it was 0.53 [0.151.92]; P 0.335, and for patients with acute MI it was 0.63 [0.291.39]; P 0.257.In patients with CAD, the coronary collateralization has a relevant protective effect. Patients with a high collateralization have a 36 reduced mortality risk compared with patients with low collateralization.