Elevated systemic inflammation, reflected by higher PIV levels, was closely associated with poorer coronary collateral development in patients with chronic total occlusion. Published in BMC Cardiovascular Disorders, this study evaluated 467 adults with NSTEMI who underwent coronary angiography and were found to have CTO.

Patients were categorized as having good or poor CCC using the Rentrop classification, and their inflammation-based markers were compared. Individuals with poor CCC had significantly higher PIV values, and multivariable analysis identified PIV as an independent predictor of impaired collateral formation (odds ratio 0.832, 95% CI 0.791–0.876, p < 0.001).

With an area under the curve (AUC) of 0.785, PIV demonstrated strong accuracy for identifying poor collateral circulation and surpassed traditional inflammation-derived indices. These findings highlight PIV as a promising, easily obtainable biomarker for assessing collateral adequacy in NSTEMI patients with CTO.