Plasma hyaluronan and collateral development in patients with coronary artery disease.

OBJECTIVE: In-vivo studies have shown that hyaluronan (HA) can promote angiogenesis and arteriogenesis, which results in accelerated collateral development. This study is aimed at investigating the association between plasma HA levels and the extent of coronary collaterals, in patients with coronary artery disease. METHODS: A total of 253 consecutive patients, who underwent coronary angiography, were divided into three groups according to coronary angiograms: normal group, 81 patients with normal coronary angiographic findings; poor collateral group, 98 patients with at least one coronary stenosis of at least 75%, but without visible collateral circulation; good collateral group, 74 patients with at least one coronary stenosis of at least 75% with well-developed collateral circulation. Plasma HA levels were measured by radioimmunoassay. The correlation between HA levels and the extent of coronary collaterals according to the Cohen-Rentrop classification was calculated by cumulative logits models. RESULTS: Plasma HA levels were 43.71+/-2.91, 61.77+/-4.10, and 131.97+/-11.76 ng/ml, for patients in the normal, poor collateral, and good collateral groups, respectively. The good collateral group had significantly higher plasma HA levels than the poor collateral (P<0.001) and normal group (P<0.001), whereas there was no significant difference between the normal and poor collateral group. HA levels elevated with increasing Rentrop score, and the cumulative logits model showed a strong graded association between plasma HA levels and the collateral Cohen-Rentrop score (odds ratio=1.021, chi2=17.811, 95% confidence interval: 1.011-1.031, P=0.000). CONCLUSION: This study suggests that elevated plasma HA levels are associated with a significant enhancement in coronary collateralization. HA may serve as a novel potential biomarker for collateral formation in patients with coronary artery disease.