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Scientific letters
Effect of statin treatment on coronary collateral flow in patients with coronary artery disease
  1. S Zbinden,
  2. N Brunner,
  3. K Wustmann,
  4. M Billinger,
  5. B Meier,
  6. C Seiler
  1. Department of Cardiology, University Hospital, Bern, Switzerland
  1. Correspondence to:
    Professor Christian Seiler
    Department of Cardiology, University Hospital, Inselspital, Freiburgstrasse, CH-3010 Bern, Switzerland; christian.seiler.cardioinsel.ch

https://doi.org/10.1136/hrt.2003.017871

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    Recent work has suggested an angiogenic,1 and conversely, an angiostatic2 or biphasic effect of statins.3 However, such hypotheses have been tested only in vitro or in animal models. The influence of statins on human arteriogenesis, the formation of collateral arteries, nowadays thought to be necessary to save myocardium from ischaemia, has not been previously investigated.

    METHODS

    Five hundred patients with stable one to three vessel coronary artery disease (CAD) and without Q wave myocardial infarction underwent quantitative assessment of the coronary collateral circulation during coronary angioplasty. The patients were divided into two different groups according to the use of statins (termed “statin group”, n  =  186) or the absence of statin treatment (termed “no statin group”, n  =  314). All patients underwent left heart catheterisation, including biplane left ventricular angiography and coronary angiography for diagnostic purposes. Aortic pressure was recorded using the angioplasty catheter. Coronary artery stenoses were assessed quantitatively as per cent lumen diameter reduction, using the guiding catheter for calibration. Collateral vessel assessment was performed by three …

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