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Collateral vessels reduce mortality

W. Schaper
DOI: http://dx.doi.org/10.1093/eurheartj/ehr385 564-566 First published online: 20 October 2011

This editorial refers to ‘The impact of the coronary collateral circulation on mortality: a meta-analysis’, by P. Meier et al., on page 614

Christian Seiler, Pascal Meier, and their co-workers of the University Hospital in Bern, Switzerland, well known for their pioneering clinical work on the collateral circulation of the heart, have described a meta-analysis of 12 studies involving 6529 patients of the role played by the collateral circulation in mortality.1 The authors come to the conclusion that the ‘coronary collateralization has a relevant protective effect’. Mortality is reduced by 36% in patients with, compared with those without, demonstrable collaterals.

This is a very important statement about a situation that most cardiologists believed that they knew from anecdotal evidence: patients with all three epicardial arteries occluded but without infarctions, in some cases even without typical ischaemic symptoms, die from an unrelated cause and with the post-mortem finding of long-standing major coronary artery disease, again without sign of infarction.24 …

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