CORONARY ARTERY ECTASIA: A RARE FORM OF CORONARY ARTERY DISEASE AND CORONARY ANOMALY

AbstractBackgroundCoronary artery anomalies are a heterogeneous group of congenital disorders presenting with a wide spectrum of symptoms, ranging from vague chest pain to sudden cardiac death. Despite available data, there is no consensus about the classification, nomenclature, and outcomes of coronary anomalies in the normally connected heart. In this study, we aimed to investigate clinical and angiographic characteristics of coronary arterial anomalies, as well as the frequency of atherosclerotic involvement in anomalous coronaries, diagnosed at a tertiary referral centre.MethodsWe retrospectively reviewed coronary angiograms performed between 2011 and 2015 for the presence of a coronary anomaly. A total of 111 patients with a final diagnosis of coronary anomaly were included in the study group. We also recruited 110 age- and sex-matched patients who underwent coronary angiography because of symptomatic coronary artery disease as controls.ResultsAmong 36,893 coronary angiograms, 111 (0.30%) major coronary anomalies were found. Compared with controls, the prevalence of significant atherosclerotic coronary disease was lower in patients with coronary anomalies and stable symptoms (p=0.02); however, the prevalence of significant coronary atherosclerosis was similar among patients admitted with unstable angina or myocardial infarction (p>0.05). Compared with controls, patients with an anomalous left anterior descending coronary artery had significantly less atherosclerotic involvement than those in whom the left anterior descending artery was not anomalous (p=0.005).ConclusionsAlthough coronary artery anomalies are cited as a cause for myocardial ischaemia, atherosclerotic coronary artery disease is also frequent and may offer an alternative explanation to ischaemic symptoms. No predisposition to accelerated atherosclerosis was found, however, and atherosclerotic involvement was less frequent in some anomalous vessels.

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Among Ectasia Patients with Coexisting Coronary Artery Disease, TIMI Frame Count Correlates with Ectasia Size and Markis Type IV Is the Commonest

Cardiology Research and Practice ◽

10.1155/2015/282170 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Hasahya Tony ◽

Kai Meng ◽

Bangwei Wu ◽

Qiutang Zeng

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Coronary Angiography ◽

Flow Velocity ◽

Coronary Arteries ◽

Coronary Flow ◽

Coronary Artery Ectasia ◽

Timi Frame Count ◽

Type Iv ◽

Artery Disease

Background. Coronary artery ectasia (CAE) occurs in 0.3 to 5.3% of patients undergoing coronary angiography. TIMI frame count (TFC) is an index of coronary flow that correlates with flow velocity. In ectasia patients, there is delayed coronary flow with increased TFC.Methods.We evaluated angiograms of 789 patients for presence of CAE, coronary artery disease (CAD), and Markis type of CAE. We measured ectasia size and length and their correlation with TFC in ectatic right coronary arteries (RCA) of patients with CAE and CAD.Results.30 patients had CAE (3.8%). Of these 16.7% had isolated CAE, while 83.87% had CAE and CAD. Among CAE and CAD patients, the RCA was most involved (70.4%), and Markis type IV CAE was the commonest (64%). In isolated CAE, the RCA, LAD, and LCx were equally involved (33.3%). Patients with CAE and CAD had significantly higher TFC compared to controls,P=0.035. There was a positive correlation of moderate strength, between ectasia size and TFC,r(17) = 0.598,P=0.007. Ectasia length was not significantly correlated with TFC, rho (17) = 0.334,P=0.163.Conclusion.Among patients undergoing angiography, CAE has a prevalence of 3.8% and Markis type IV is the commonest. Larger ectasias are associated with slower coronary flow.

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Inflammatory response in patients with coronary artery ectasia and coronary artery disease

Kardiologia Polska ◽

10.33963/kp.14812 ◽

2019 ◽

Author(s):

Sylwia Iwańczyk ◽

Michał Borger ◽

Mikołaj Kamiński ◽

Ewa Chmara ◽

Artur Cieślewicz ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Inflammatory Response ◽

Coronary Artery Ectasia ◽

Artery Disease

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Clinical and Angiographic Features of Patients with Coronary Artery Ectasia Compared with Stenotic Coronary Artery Disease

Journal of Cardiology & Current Research ◽

10.15406/jccr.2017.09.00328 ◽

2017 ◽

Vol 9 (4) ◽

Cited By ~ 1

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Coronary Artery Ectasia ◽

Artery Disease

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Abstract 433: Coronary Artery Ectasia in Patients with Obstructive Coronary Artery Disease

Arteriosclerosis Thrombosis and Vascular Biology ◽

10.1161/atvb.35.suppl_1.433 ◽

2015 ◽

Vol 35 (suppl_1) ◽

Author(s):

Shasha Xu ◽

Jianjun Jiang ◽

Huanhuan Zhu ◽

Bing Wang ◽

Congfeng Fang ◽

...

Keyword(s):

Myocardial Infarction ◽

Coronary Artery Disease ◽

Acute Myocardial Infarction ◽

Uric Acid ◽

Coronary Artery ◽

Angina Pectoris ◽

Obstructive Coronary Artery Disease ◽

Coronary Artery Ectasia ◽

Old Myocardial Infarction ◽

Artery Disease

Background and Objective: The pathophysiology of isolated coronary artery ectasia (CAE) remains poorly understood although associations between CAE and a broad spectrum of different diseases, especially atherosclerotic coronary artery disease have been reported. This study aimed to investigate the clinical characteristics of CAE and its relationship to obstructive artery disease in the Chinese Population. Methods and Results: This study recruited 3793 consecutive patients who had undergone coronary angiography for suspected coronary artery disease (CAD) between January 2009 and December 2014. The median age of the patients was 63 years (range, 27 to 94 years) and the majority (69.71%) was male. There were 3068 patients with obstructive coronary artery disease, including angina pectoris (n=1611), acute myocardial infarction (n=1265), and old myocardial infarction (n=192). A total of 120 cases (Male, n=93, female, n=27) with a median age of 63 years (range, 28-86) were identified as CAE in patients undergoing coronary angiography. Co-existent CAD was present in 94% of CAE patients, including 56 angina pectoris; 53 acute myocardial infarction; and 4 old myocardial infarction cases. The prevalence of CAE in patients with obstructive coronary artery disease was 3.67%. The frequency of arterial involvement was: right coronary artery (RCA), 63%; left anterior descending artery (LAD), 43%; left circumflex artery (LCX), 38%; and left main artery (LM), 14%. CAE affected only 1 major vessel in 83% of cases, 2 vessels in 12%, and all 3 vessels in 5%. Using multivariate analysis, serum levels of uric acid were independently associated with present of CAE (P<0.001), while other cardiovascular risk factors such age, arterial hypertension, dyslipidemia, smoking, and diabetes mellitus did not show statistically significant associations (P>0.05). Conclusion: The prevalence of CAE in patients with obstructive coronary artery disease was 3.67%. The RCA was the most commonly affected and most patients had single vessel involvement. Increased serum uric acid level may be a potential risk factor for presence of CAE.

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Comparison of neutrophil to lymphocyte ratio in patients with coronary artery ectasia versus patients with obstructive coronary artery disease

Kardiologia Polska ◽

10.5603/kp.a2013.0349 ◽

2013 ◽

pp. 372-380 ◽

Cited By ~ 1

Author(s):

Ezgi Kalaycıoğlu ◽

Tayyar Gökdeniz ◽

Ahmet Çağrı Aykan ◽

İlker Gül ◽

Faruk Boyacı ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Obstructive Coronary Artery Disease ◽

Neutrophil To Lymphocyte Ratio ◽

Coronary Artery Ectasia ◽

Lymphocyte Ratio ◽

Artery Disease

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Low High-Density Lipoprotein Cholesterol Predisposes to Coronary Artery Ectasia

Biomedicines ◽

10.3390/biomedicines7040079 ◽

2019 ◽

Vol 7 (4) ◽

pp. 79 ◽

Cited By ~ 1

Author(s):

Jafari ◽

Daum ◽

Hamed ◽

Osherov ◽

Orlov ◽

...

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

Coronary Artery ◽

High Density Lipoprotein ◽

High Density Lipoprotein Cholesterol ◽

Density Lipoprotein ◽

Lipoprotein Cholesterol ◽

Coronary Artery Ectasia ◽

Unit Increase ◽

Artery Disease

Coronary Artery Ectasia (CAE) is a phenomenon characterized by locally or diffuse coronary artery dilation of one or more coronary arteries. In the present study, the prevalence of acquired coronary ectasia and coronary risk factors for CAE was analyzed in patients undergoing cardiac catheterization for suspected ischemic heart disease. We retrospectively analyzed 4000 patients undergoing coronary angiography for suspected coronary artery disease at our cardiac catheterization unit, and a total of 171 patients were selected. The study group was divided into three groups, 65 patients with CAE, 62 patients with significant obstructive coronary artery disease, and 44 patients with normal coronary angiograms as a control group. A negative correlation was observed between high-density lipoprotein cholesterol (HDL-C) and the presence of CAE (r = –0.274, p < 0.001). In addition, HDL-C (OR, 0.858; CI, 0.749–0.984; p = 0.029), low-density lipoprotein cholesterol (LDL-C)/HDL-C ratio (OR, 1.987; CI, 1.542–2.882; p = 0.034), and hemoglobin (OR, 2.060; CI, 1.114–3.809; p = 0.021) were identified as independent risk factors for the development of CAE. In fact, we observed that a one-unit increase in HDL-C corresponded to a 15% risk reduction in CAE development and that each unit increase in hemoglobin could potentially increase the CAE risk by 2-fold. Low HDL-C could significantly increase the risk of developing CAE in healthy individuals. Elevated hemoglobin could predispose to subsequent dilation and aneurysm of the coronary artery. This work suggests that disordered lipoprotein metabolism or altered hemoglobin values can predispose patients to aneurysmal coronary artery disease.

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