关键词: 急性冠脉综合征, 侧支循环, 临床意义

Abstract: AIM: To study the relation between development of coronary collaterals and clinical outcome in patients with acute coronary syndrome (ACS).Methods: 251 patients with clinical diagnosed ACS were consecutively enrolled into the present study and divided into two groups according to the presence of coronary collaterals by quantitative coronary angiography (QCA).Serial venous blood samples were collected at admission for determining of high-sensitive C-reactive protein(hs-CRP), brain natriuretic peptide (BNP), and cardiac troponin I (cTnI).Baseline left ventricular ejection fraction(LVEF) was determined by cardiac echo.Results: Coronary collaterals were detected in 38 patients(as CC group), another 213 patients without coronary collaterals were served as control group.Serum levels of cTnI in patients in CC group was significantly higher than in control group(0.91±1.13 vs 0.29±0.23 ng·ml^-1, P<0.01).There was no differences in plasma level of hs-CRP and BNP between two groups (hs-CRP, 5.00±3.67 vs 5.66±3.83 mg·dL^-1;BNP, 828.8±757.6 vs 829.6±784.6 fmol·ml^-1, P>0.05).Serum levels of cTnI in patiemets of CC group was significantly lower than those of control group (0.29±0.23 vs 0.91±1.13 ng·ml^-1, P<0.01).Compared with patients in control group, left ventricular function in CC group was better reserved and improved(0.43±0.11 vs 0.48±0.11, P<0.01).Conclusion: The development of coronary collaterals in patients with ACS contributes to protection of left ventricular function, which is favorable to clinical outcome.

Key words: acute coronary syndromes, collateral circulation, clinical outcome