Shankar Biswas: Impact of Coronary Collaterals on Mortality in STEMI
Shankar Biswas, Medical Doctor, USMLE tutor, shared a post on Linkedin about a recent article he and his colleagues co-authored, adding:
“New publication alert
Thrilled to announce my latest first-author publication in BMC Cardiovascular Disorders (Springer Nature)!
‘Coronary Collateral Circulation and Mortality in ST-Elevation Myocardial Infarction Undergoing Primary PCI: An Updated Systematic Review and Meta-Analysis of 18,443 Patients’
In this updated meta-analysis, we pooled 26 studies comprising over 18,000 STEMI patients and found that robust coronary collaterals (Rentrop grade 2-3) were associated with 48% lower odds of mortality (OR 0.52; 95% CI 0.39-0.71; p less than 0.0001).
However, we observed an intriguing attenuation of this association in contemporary studies — likely driven by statistical dilution from declining baseline mortality rates rather than diminished biological relevance of collaterals.
Our meta-regression confirmed that higher baseline mortality predicted larger effect sizes (p equals 0.038), reinforcing that as STEMI care improves, the detectable benefit of any single prognostic factor naturally compresses.
The evidence was rated Low certainty (Grade), highlighting that collateral assessment should be viewed as prognostic rather than a basis for therapeutic decisions.
A huge thank you to my amazing co-authors Yashasvi Srivastava and Ayman Hamadttu for their dedication and hard work throughout this project.
This wouldn’t have been possible without your contributions!
Every publication is a step forward in contributing to evidence-based medicine.
Grateful for this journey and excited for what’s ahead! ”
Title: Coronary collateral circulation and mortality in ST-elevation myocardial infarction undergoing primary PCI: an updated systematic review and meta-analysis of 18,443 patients
Authors: Shankar Biswas, Yashasvi Srivastava, Ayman Hamadttu
Read the Full Article on BMC Cardiovascular Disorders
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