Abstract
Background. The development of coronary collaterals is variable among patients with coronary artery disease and remains incompletely understood. We aimed to demonstrate the predictors of poorly developed coronary collateral circulation (CCC) in patients with subclinical hypothyroidism suffered from chronic stable angina.Methods. The study was conducted on 226 patients with subclinical hypothyroidism suffered from chronic stable angina, coronary angiography documented total occlusion at any major coronary artery or coronary artery lumen diameter stenosis >90%. Patients were divided into two groups according to grade of CCC, group A: 138 patients with (good collaterals) and group B: 88 patients with (poor collaterals). To classify CCC, we used Rentrop’s classification.Results. Multivariate regression analysis was performed and identified the independent predictors of poor coronary collaterals: N/L ratio (OR 0.413, CI 95% [0.172–0.993], p = 0.048), and TSH (OR 2.511, CI 95% [1.784–3.534], p = 0.001). The ROC analysis provided a cut-off value of >4.6 for N/L ratio, and >9 µIU/mL for TSH to predict poor coronary collaterals.Conclusion. An elevated level of N/L ratio >4.6 and TSH level >9 µIU/mL were the independent predictors of poorly developed CCC in patients with subclinical hypothyroidism suffered from chronic stable angina.
Highlights
Coronary artery disease (CAD) is one of the most common causes of morbidity and mortality worldwide
Our objective was to investigate the most important predictors of poor collateral circulation (CCC), as evaluated by coronary angiography in patients with subclinical hypothyroidism suffered from chronic stable angina
The study included 226 subclinical hypothyroidism patients with stable coronary artery disease who presented for elective coronary angiography and documented total occlusion at any major coronary artery or coronary artery lumen diameter stenosis >90%
Summary
Coronary artery disease (CAD) is one of the most common causes of morbidity and mortality worldwide. The number of collaterals and the extent of their coverage are associated with improved survival in patients with CAD. These anastomoses are often incapable of restoring flow to normal levels, but help in alleviating episodes of myocardial ischemia, enhancing residual myocardial contractility, reducing infarct size, preserving left ventricular function, reducing coronary atherosclerotic disease progression and decreasing mortality[3,4]. We aimed to demonstrate the predictors of poorly developed coronary collateral circulation (CCC) in patients with subclinical hypothyroidism suffered from chronic stable angina. An elevated level of N/L ratio >4.6 and TSH level >9 μIU/mL were the independent predictors of poorly developed CCC in patients with subclinical hypothyroidism suffered from chronic stable angina
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