Extent of coronary collateral vessel decrease with advanced age

Objective - Animal experiments show that angiogenesis, responsible for the development of collaterals, impairs with increasing age. We retrospectively investigated the relationship between the extent of coronary collaterals and age in patients who had total occlusion in at least one of their epicardial coronary arteries. Methods and results - The records of 2160 consecutive patients who had undegone coronary angiography were examined. The coronary collaterals of the 720 patients who had total occlusion in at least one epicardial artery were evaluated according to the Rentrop scoring system. The patients were divided into four groups according to age: age <50 years (group 1), greater than or equal to50 years and <60 years (group 2), greater than or equal to60 years and <70 years (group 3) and >70 years (group 4). A Rentrop score of 1 to 3 was accepted as a reliable measure of presence of coronary collaterals. The gender distribution was statistically comparable among the groups. The percentage of the coronary collaterals was as follows: 67% in group 1, 47% in group 2, 48% in group 3 and 28% in group 4. The extent of coronary collaterals was significantly lower in group 4 compared with group 1 (p < 0.01). Conclusion - The extent of coronary collaterals seems to decrease significantly with advanced age.