Impacts of Antihypertensive Drugs on Coronary Collateral Development

Purpose: Increase in the number of coronary imaging has caused us to encounter patients with chronic total occlusion (CTO) more often in daily practice. Although clinical trials have demonstrated the importance of collateral circulation, which has significant functions in ischemic myocardial cells, factors affecting the development of collateral circulation remain unclear. Our study aimed to investigate the impact of antihypertensive drugs on collateral development. Materials and Methods: Our retrospective cohort study included 107 patients who were detected to CTO as a result of coronary angiography (CAG) and had been regularly taking the antihypertensive drug for more than six months. The patients were divided into two groups according to the Rentrop classification. Results: Statistically well-developed collaterals were observed in patients using angiotensin-converting enzyme (ACE) inhibitors for more than six months (p<0.001). The multivariate regression analysis showed that among the medicines, the use of ACE inhibitors is associated with well-developed collaterals (Odds ratio [OR]:7.500, 95% confidence interval [CI]: 2.345-23.984, p=0.001). Conclusion: Using ACE inhibitor for more than six months affects coronary collateral development positively. The ACE inhibitor group should be prioritized when choosing the antihypertensive drug because they will contribute to collateral development in CTO patients who are considered for a medical follow-up.