Pan-immune inflammation value as a determinant of coronary collateral circulation in patients with chronic coronary syndrome and chronic total occlusion

Aims: This study aimed to investigate the association between coronary collateral circulation (CCC) pan-immune-inflammation value (PIV) in patients with chronic coronary syndrome (CCS) and chronic total occlusion (CTO). Methods: The study included 297 patients with CCS who underwent coronary angiography and had CTO in at least one major coronary artery. Patients with CTO were categorized into two groups based on Rentrop grading: group 1 (grades 2–3, well developed CCC) and group 2 (grades 0–1, poor CCC). Results: Patients with poor CCC had higher WBC levels (p=0.04), neutrophil counts (p=0.001), platelet counts (p=0.023), and median PIV values (p=0.003) compared to patients with well-developed CCC. Logistic regression identified PIV (per hundred units) as an independent predictor of poor CCC (OR=1.10, 95% [CI=1.02–1.23], p=0.044). Receiver operating characteristic (ROC) analysis demonstrated that a cut-off value of 168 for PIV predicted poor CCC slightly better compared to other markers, with 94.6% sensitivity and 22.8% specificity (area under the curve=0.601, 95% CI=0.543–0.657, p=0.002). Conclusion: These findings indicate that PIV may serve as an independent predictor of CCC development.