Coronary disease & ACS

The Role of the Collateral Circulation in Stable Angina: An Invasive Placebo-Controlled Study

CirculationPublished Mechanistic study

Authors' conclusion

Coronary collateralization is associated with ischemic burden and may reduce the intensity of ischemic chest pain.

Study context

Population
Patients with severe single-vessel CAD and angina, antianginal medications stopped
Participants
51 patients
Comparison
Balloon occlusion vs audiovisually identical placebo inflation, in randomized order
Methodological detailsplacebo-controlled, n-of-1, invasive
  • Placebo-controlled
  • n-of-1
  • Invasive

Main finding

As reported in the abstract

Associations of ischaemia, collateral flow and angina (Somers' D, Bayesian Pr)
Daily angina frequency vs FFR: little correlation
Somers' D 0.124, Pr=0.057
Daily angina frequency vs iFR: little correlation
Somers' D 0.056, Pr=0.150
Lower FFR and greater collateral flow: strong evidence of association
Somers' D 0.302, Pr=0.998
Lower iFR and greater collateral flow: strong evidence of association
Somers' D 0.316, Pr=0.999
Higher collateral flow index and lower pain intensity scores: strong evidence of association
Somers' D 0.341, Pr=0.999

Original publication

The Role of the Collateral Circulation in Stable Angina: An Invasive Placebo-Controlled Study. Circulation. Published 27 October 2025. doi:10.1161/circulationaha.125.074687

Summarised from the published abstract; every number is checked against it

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