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2.
Lipids Health Dis ; 23(1): 240, 2024 Aug 06.
Artículo en Inglés | MEDLINE | ID: mdl-39107777

RESUMEN

OBJECTIVE: Coronary artery ectasia (CAE) is a condition characterized by the localized or widespread dilation of one or more coronary arteries. The majority of CAE patients do not present with clinical symptoms, and the exact cause of CAE remains unclear. Therefore, a retrospective analysis was conducted to explore the potential causes of CAE. METHODS: This study was a retrospective analysis of patients who underwent coronary angiography at Guangdong Provincial People's Hospital between January 2017 and July 2022, of whom 679 patients were ultimately enrolled in the study. Among them, 260 patients were diagnosed with CAE, whereas 419 patients with normal coronary results composed the control group. Remnant cholesterol (RC) was calculated as total cholesterol (TC) minus high-density lipoprotein cholesterol (HDL-C) minus low-density lipoprotein cholesterol (LDL-C). The association between RC levels and the risk of CAE was assessed via multivariable logistic models. RESULTS: Out of the 679 patients who participated in this study, with an average age of 59.9 years, 38.3% were diagnosed with CAE. Patients with CAE had higher RC levels than did those without CAE (P = 0.001). A significant positive association was observed between RC levels and the risk of CAE, with a multivariable adjusted odds ratio (OR) of 1.950 (95% confidence interval [CI]: 1.163-3.270). There was a significant positive association between RC levels and the risk of CAE in both single-vessel and multivessel dilation cases, as well as in isolated CAE and dilation secondary to coronary atherosclerosis. According to the subgroup analyses, RC levels were positively associated with the risk of CAE in participants with hypertension (OR, 1.065; 95% CI, 1.034-1.098). CONCLUSION: RC levels are positively correlated with CAE, implying that a focus on RC could be beneficial in CAE research.


Asunto(s)
HDL-Colesterol , LDL-Colesterol , Colesterol , Angiografía Coronaria , Enfermedad de la Arteria Coronaria , Vasos Coronarios , Humanos , Persona de Mediana Edad , Masculino , Femenino , Estudios Transversales , Colesterol/sangre , Dilatación Patológica/sangre , Estudios Retrospectivos , Enfermedad de la Arteria Coronaria/sangre , Enfermedad de la Arteria Coronaria/patología , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Anciano , LDL-Colesterol/sangre , Vasos Coronarios/patología , Vasos Coronarios/diagnóstico por imagen , HDL-Colesterol/sangre , Factores de Riesgo , Triglicéridos/sangre , Oportunidad Relativa
3.
Int J Cardiol ; 414: 132412, 2024 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-39089480

RESUMEN

BACKGROUND: Treatment of isolated and non-obstructive atherosclerotic coronary artery ectasia (CAE) is still controversial. AIM: To assess the efficacy and safety of vitamin-K antagonist (VKA) versus dual antiplatelet (DAPT) therapy in management of patients with isolated and non-obstructive atherosclerotic CAE. METHODS: We prospectively enrolled 79 patients diagnosed on elective coronary angiography to have either isolated CAE or non-obstructive atherosclerotic CAE. Patients were assigned in 1:1 pattern to receive either VKA (warfarin) or DAPT (aspirin plus clopidogrel). Patients were followed-up for nine-months. The primary endpoint was the cumulative events rate including acute coronary event, target vessel intervention, or cardiac death. Analysis of cumulative events at different time intervals, its individual components, and bleeding were considered secondary endpoints. RESULTS: Cumulative events rate was 33%, with mortality rate of 2.5%. Both treatment groups showed comparable cumulative events during the nine-months follow-up duration. Nevertheless, Kaplan-Meier analysis beyond the first 3-months of follow-up showed significantly higher event-free survival among the VKA-group. Recurrent events (≥2) were significantly higher among the DAPT-group. Both groups showed no major bleeding events. Multivariable cox-regression analysis showed that presence of significant coronary tortuosity, use of DAPT in reference to VKA, and lower percent time in therapeutic range (%TTR) among those receiving VKA were significant independent predictors of clinical adverse events beyond the first 3-months of follow-up. CONCLUSION: Cumulative adverse events were comparable among both treatment groups for isolated non-obstructive CAE. However, adverse events were significantly more frequent in the DAPT-group beyond the first three months.


Asunto(s)
Enfermedad de la Arteria Coronaria , Terapia Antiplaquetaria Doble , Inhibidores de Agregación Plaquetaria , Vitamina K , Humanos , Masculino , Femenino , Persona de Mediana Edad , Estudios Prospectivos , Anciano , Inhibidores de Agregación Plaquetaria/uso terapéutico , Inhibidores de Agregación Plaquetaria/administración & dosificación , Vitamina K/antagonistas & inhibidores , Enfermedad de la Arteria Coronaria/tratamiento farmacológico , Estudios de Seguimiento , Terapia Antiplaquetaria Doble/métodos , Resultado del Tratamiento , Angiografía Coronaria , Dilatación Patológica , Aspirina/uso terapéutico , Aspirina/administración & dosificación , Clopidogrel/uso terapéutico , Clopidogrel/administración & dosificación , Anticoagulantes/uso terapéutico , Anticoagulantes/administración & dosificación , Manejo de la Enfermedad , Warfarina/uso terapéutico , Warfarina/administración & dosificación , Warfarina/efectos adversos
4.
Clin Case Rep ; 12(8): e9276, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-39135774

RESUMEN

Coronary occlusion due to large thrombus is frequently encountered during ST-elevation myocardial infarction (STEMI). Despite guidelines discourage this practice, often thrombus aspiration is necessary to reduce thrombotic burden and to prevent embolization. We report a case of mechanical thrombectomy with a Neurovascular Catheter from radial artery during inferior STEMI.

5.
Indian Heart J ; 2024 Jul 14.
Artículo en Inglés | MEDLINE | ID: mdl-39009077

RESUMEN

INTRODUCTION: Coronary artery ectasia (CAE), widenings in sections of the arteries, is a rare condition found in up to 3-5% of angiography cases. Sometimes recurrence of major adverse cardiac events (MACE) has been reported in the CAE subjects. The present systematic review aims to collect and summarize reports on whether the use of anticoagulants in addition to single antiplatelet/dual antiplatelet therapy (SAPT/DAPT) in CAE patients with significant occlusion/heavy thrombus is efficient and safe in decreasing the incidence/recurrence of MACE. MATERIAL AND METHODS: A systematically comprehensive search was performed covering PubMed, Scopus, ISI Web of Science, and Google Scholar databases. RESULTS: Twenty-five studies were found including 20 case reports, four case series, and one randomized clinical trial. Of 20 case reports 15 were male (75 %), and five were female (25 %). Of the four the case series, all showed positive outcomes after DAPT plus anticoagulant in more than 50 % of patients; two took only DAPT and 13 took anticoagulant ± DAPT, and five compared both. Cases received DAPT only experienced recurrences of MACE. The other cases were uneventful with less MACE and better outcomes after the use of anticoagulant ± DAPT. Results of these case-series included 457 CAE patients showed that more than 80 % of subjects were male, and in all studies tailored pharmacological interventions, including antiplatelet and anticoagulant (warfarin) therapies, resulted in less MACE and mortality. CONCLUSION: It can be concluded that antiplatelet (SAPT/DAPT) must be applied in combination with anticoagulants to provide more efficient protection against MACE in CAE patients. However, further high-quality randomized clinical trials are needed to confirm the results.

6.
Caspian J Intern Med ; 15(2): 244-250, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38807718

RESUMEN

Background: The prevalence of Coronary artery ectasia (CAE) varies from 0.|3 to 5% in different countries. The prevalence of CAE has varied in different parts of the world and the study of risk factors can be effective in the process of diagnosis and treatment of patients, we reviewed patients who underwent coronary angiography for 5 years to determine the prevalence of isolated CAE and its associated risk factors. Methods: A retrospective analysis was conducted on 16600 patients who underwent coronary angiography at Shahid Sadoughi and Afshar hospitals between March 2015 to April 2020. Diagnosis and confirmation of CAE was defined as a vessel diameter greater than 1.5 times the normal diameter of the vessel, which must be confirmed by at least two cardiologists. Demographic variables, angiography and echocardiography reports were included in our final analysis. Results: Isolated CAE was diagnosed in 287 (1.7%) patients. After triple-vessel disease (53%), the left anterior descending artery (LAD) was the commonest affected vessel by ectasia 16% (46 cases). Diffuse isolated CAE was diagnosed in 52% of LAD, 76.6% of Right coronary artery (RCA), and 74.1% of left circumflex artery. A significant association was seen between the vessel involved and the nature of ectasia (p<0.001). Conclusion: In our study, the occurrence of isolated CAE was similar to other studies. This condition often affects all three major vessels of the coronary arteries, and is commonly categorized as type 1, which involves diffuse involvement of the arteries based on the Markis and Harikrishnan Classification.

7.
Gene ; 916: 148450, 2024 Jul 20.
Artículo en Inglés | MEDLINE | ID: mdl-38588932

RESUMEN

BACKGROUND: Although the implication of receptor of advanced glycation endproducts (RAGE) has been reported in coronary artery disease, its roles in coronary artery ectasia (CAE) have remained undetermined. Furthermore, the effect of RAGE polymorfisms were not well-defined in scope of soluble RAGE (sRAGE) levels. Thus, we aimed to investigate the influence of the functional polymorphisms of RAGE -374T > A (rs1800624) and G82S (rs2070600) in CAE development. METHODS: This prospective observational study was conducted in 2 groups selected of 2452 patients who underwent elective coronary angiography (CAG) for evaluation after positive noninvasive heart tests. Group-I included 98 patients with non-obstructive coronary artery disease and CAE, and Group-II (control) included 100 patients with normal coronary arteries. SNPs were genotyped by real-time PCR using Taqman® genotyping assay. Serum sRAGE and soluble lectin-like oxidized receptor-1 (sOLR1) were assayed by ELISA and serum lipids were measured enzymatically. RESULTS: The frequencies of the RAGE -374A allele and -374AA genotype were significantly higher in CAE patients compared to controls (p < 0.001). sRAGE levels were not different between study groups, while sOLR1 levels were elevated in CAE (p = 0.004). In controls without systemic disease, -374A allele was associated with low sRAGE levels (p < 0.05), but this association was not significant in controls with HT. Similarly, sRAGE levels of CAE patients with both HT and T2DM were higher than those no systemic disease (p = 0.02). The -374A allele was also associated with younger patient age and higher platelet count in the CAE group in both total and subgroup analyses. In the correlation analyses, the -374A allele was also negatively correlated with age and positively correlated with Plt in all of these CAE groups. In the total CAE group, sRAGE levels also showed a positive correlation with age and a negative correlation with HDL-cholesterol levels. On the other hand, a negative correlation was observed between sRAGE and Plt in the total, hypertensive and no systemic disease control subgroups. Multivariate logistic regression analysis confirmed that the -374A allele (p < 0.001), hyperlipidemia (p < 0.05), and high sOLR1 level (p < 0.05) are risk factors for CAE. ROC curve analysis shows that RAGE -374A allele has AUC of 0.713 (sensitivity: 83.7 %, specificity: 59.0 %), which is higher than HLD (sensitivity: 59.2 %, specificity: 69.0 %), HT (sensitivity: 62.4 %, specificity: 61.1 %) and high sOLR1 level (≥0.67 ng/ml)) (sensitivity: 59.8 %, specificity: 58.5 %). CONCLUSION: Beside the demonstration of the relationship between -374A allele and increased risk of CAE for the first time, our results indicate that antihypertensive and antidiabetic treatment in CAE patients causes an increase in sRAGE levels. The lack of an association between the expected -374A allele and low sRAGE levels in total CAE group was attributed to the high proportion of hypertensive patients and hence to antihypertensive treatment. Moreover, the RAGE -374A allele is associated with younger age at CAE and higher Plt, suggesting that -374A may also be associated with platelet activation, which plays a role in the pathogenesis of CAE. However, our data need to be confirmed in a large study for definitive conclusions.


Asunto(s)
Enfermedad de la Arteria Coronaria , Polimorfismo de Nucleótido Simple , Receptor para Productos Finales de Glicación Avanzada , Humanos , Femenino , Masculino , Persona de Mediana Edad , Receptor para Productos Finales de Glicación Avanzada/genética , Receptor para Productos Finales de Glicación Avanzada/sangre , Enfermedad de la Arteria Coronaria/genética , Enfermedad de la Arteria Coronaria/sangre , Estudios Prospectivos , Anciano , Dilatación Patológica/genética , Predisposición Genética a la Enfermedad , Receptores Depuradores de Clase E/genética , Vasos Coronarios/metabolismo , Vasos Coronarios/patología , Estudios de Casos y Controles , Alelos , Angiografía Coronaria , Frecuencia de los Genes , Genotipo , Proteínas Relacionadas con Receptor de LDL , Proteínas de Transporte de Membrana
8.
Biochem Genet ; 2024 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-38625594

RESUMEN

Coronary artery ectasia (CAE), defined as a 1.5-fold or greater enlargement of a coronary artery segment compared to the adjacent normal coronary artery, is frequently associated with atherosclerotic coronary artery disease (CAD). Membrane-bound endothelin converting enzyme-1 (ECE-1) is involved in the maturation process of the most potent vasoconstrictor ET-1. Polymorphisms in the endothelin (ET) gene family have been shown associated with the development of atherosclerosis. This study aims to investigate the effects of rs213045 and rs2038089 polymorphisms in the ECE-1 gene which have been previously shown to be associated with atherosclerosis and hypertension (HT), in CAE patients. Ninety-six CAE and 175 patients with normal coronary arteries were included in the study. ECE-1b gene variations rs213045 and rs2038089 were determined by real-time PCR. The frequencies of rs213045 C > A (C338A) CC genotype (60.4% vs. 35.4%, p < 0.001) and rs2038089 T > C T allele (64.58% vs. 35.42%, p = 0.017) were higher in the CAE group compared to the control group. The multivariate regression analysis showed that the ECE-1b rs213045 CC genotype (p = 0.001), rs2038089 T allele (p = 0.017), and hypercholesterolemia (HC) (p = 0.001) are risk factors for CAE. Moreover, in nondiabetic individuals of the CAE and control groups, it was observed that the rs213045 CC genotype (p < 0.001), and rs2038089 T allele (p = 0.003) were a risk factor for CAE, but this relationship was not found in the diabetic subgroups of the study groups (p > 0.05). These results show that ECE-1b polymorphisms may be associated with the risk of CAE and this relationship may change according to the presence of type II diabetes.

10.
Cureus ; 16(1): e52081, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38344548

RESUMEN

A coronary artery aneurysm (CAA) is defined as the dilatation of a vessel with a diameter of ≥1.5 times that of the adjacent normal vessel. Occasionally, aneurysms can be large enough to be characterized as giant CAAs, but there is no universally accepted definition. We discuss the case of a 45-year-old male patient who presented to the hospital with substernal chest pain. His ECG revealed ST depression and T wave inversions in precordial leads. Cardiac biomarkers were within normal limits. Due to concerns about coronary artery disease, cardiac catheterization was done, which revealed CAAs in the distribution of the right coronary artery (RCA), left anterior descending (LAD) and left circumflex (LCX) artery. The patient was at high risk for surgical intervention given coexisting severe pulmonary hypertension. Therefore, medical treatment was initiated with beta-blockers, high-intensity statin, and anticoagulation with warfarin. In a two-month follow-up, the patient remained asymptomatic without any residual symptoms. A CAA can present as an acute coronary syndrome. The treatment still evolves, involving medical management and/or percutaneous or surgical interventions.

11.
Cureus ; 16(1): e52747, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38384654

RESUMEN

Coronary artery ectasia (CAE) is characterized by the abnormal dilation of coronary arteries, resulting in disturbed or slow blood flow, which causes angina pectoris-the most prevalent symptom of CAE. To date, there is no consensus on the therapeutic management of CAE due to its rarity and the scarcity of research. We present a case series of five patients with different ethnicities, including both men and women, whose CAE was successfully managed by the administration of ranolazine. All five patients were found to have CAE by coronary angiography, which was also associated with slow blood flow. Clinically, the patients had accelerating angina. They were prescribed an initial dose of 500 mg of ranolazine twice daily, which led to the resolution of their anginal symptoms. They have been clinically and hemodynamically stable for the last several years. In light of these results, we propose that ranolazine be considered as a first-choice anti-anginal medication for patients with CAE.

12.
Clin Case Rep ; 11(12): e8151, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38046800

RESUMEN

There was an 83-year-old man having coronary artery disease associated with coronary artery ectasia who occurred ventricular fibrillation suddenly during coronary artery angiography. As Kawasaki disease was suspected to the most likely reason which led to coronary artery lesion.

14.
BMC Cardiovasc Disord ; 23(1): 536, 2023 11 03.
Artículo en Inglés | MEDLINE | ID: mdl-37924047

RESUMEN

BACKGROUND: Population-wide, paraganglioma (PGL) is uncommon. The incidence of Takotsubo syndrome (TTS) ranges from 0.5% to 0.9% and also is an exceedingly rare manifestation of PGL. Coronary artery ectasia (CAE) is also uncommon, with an incidence ranging from 1.2% to 4.9%. Herein, we present a case of PGL, TTS, and Markis type I CAE that occured in the same patient. CASE PRESENTATION: A man in his early 40s was admitted to our hospital with a 16-hour history of abdominal colic. Computed tomography and laboratory examination led to the diagnosis of PGL, coronary angiography led to the diagnosis of Markis type I or Chinese type III CAE, and two echocardiographic examinations led to the diagnosis of TTS. When the patient was treated by phenoxybenzamine instead of surgery for the PGL, his blood pressure and glucose level gradually returned to normal. The CAE was treated by thrombolysis, antiplatelet medications, atorvastatin, and myocardial protection therapies. No symptoms of PGL, CAE, or TTS were seen during a 6-month follow-up, and the patient had an excellent quality of life. We confirmed that phenoxybenzamine was the cause of the TTS because paradoxical systolic motion of the apex, inferior wall, left ventricular anterior wall, and interventricular septum were similarly recovered when the PGL was treated by phenoxybenzamine. CONCLUSIONS: To raise awareness of this illness and prevent misdiagnosis, we have herein presented a case of TTS that was brought on by PGL with Markis type I CAE for clinicians' reference. In addition, in clinical practice, we should consider the possibility of a concomitant coronary artery disease even if the TTS is caused by a PGL-induced catecholamine surge.


Asunto(s)
Aneurisma Coronario , Cardiomiopatía de Takotsubo , Enfermedades Vasculares , Humanos , Masculino , Angiografía Coronaria/métodos , Vasos Coronarios , Dilatación Patológica , Fenoxibenzamina , Calidad de Vida , Factores de Riesgo , Síndrome , Cardiomiopatía de Takotsubo/diagnóstico por imagen , Cardiomiopatía de Takotsubo/terapia , Adulto
15.
JACC Case Rep ; 24: 102044, 2023 Oct 18.
Artículo en Inglés | MEDLINE | ID: mdl-37869214

RESUMEN

We present a case of recurrent myocardial infarction with coronary artery ectasia that had progressive dilation. Both implanting drug-eluting stent and antithrombotic therapy with warfarin plus P2Y12 inhibitor were feasible. The careful follow-up including morphologic evaluation may be needed for this specific lesion. (Level of Difficulty: Intermediate.).

16.
Genet Test Mol Biomarkers ; 27(9): 290-298, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37768331

RESUMEN

Background: Coronary artery ectasia (CAE), known for localized or diffuse excessive dilatation of the coronary artery, has an unknown etiology, but it has been reported that the underlying cause may be atherosclerosis and genetic changes that may affect the arterial lumen. MicroRNAs have been shown to have an effect in aneurysm diseases and are known to contribute to vascular development and atherosclerosis. The purpose of this study was to investigate whether they are also associated with CAE. Methods: This cross-sectional study consisted of 25 patients with CAE and 25 subjects with normal coronary arteries. Blood was collected and miRNA expression was detected using the Rotor-GeneQ real-time polymerase chain reaction cycler (Qiagen) to investigate expression levels of miR-24-1-5p, miR-34a-5p, miR-126-5p, miR-143-5p, and miR-145-5p. Results: Demographic variables of CAE (mean age 59.5 ± 1.7; 12 women) and controls (mean age 57.2 ± 2.1; 16 women) were similar. miR-126-5p (p = 0.014) and miR-145-5p (p = 0.003) levels were found to be <2-fold upregulated in CAE compared to controls; miR-143-5p also showed upregulation, but it was not significant (p = 0.078). Conversely, miR-24-1-5p (p = 0.032) levels were downregulated in CAE compared to controls. miR-34a-5p was also downregulated, but this was not considered significant (p = 0.185). Conclusions: According to our study findings, miR-126-5p, miR-145-5p, and miR-24-1-5p may be associated with CAE. These microRNAs could be of diagnostic and therapeutic significance for further studies of CAE involving abnormal angiogenesis and vascular disorders and potentially serve as useful biomarkers.


Asunto(s)
Aneurisma , Aterosclerosis , MicroARNs , Humanos , Femenino , Persona de Mediana Edad , Dilatación Patológica/genética , MicroARNs/genética , Vasos Coronarios , Estudios Transversales , Aterosclerosis/genética
17.
Clin Case Rep ; 11(9): e7870, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37670817

RESUMEN

Key Clinical Message: Although the combination of hypertrophic cardiomyopathy and slow flow coronary artery is a rare phenomenon, but a comprehensive evaluation of these patients is essential. Because timely diagnosis and treatment can prevent irreversible complications. Abstract: Hypertrophic cardiomyopathy-related coronary artery ectasia and slow flow phenomena is an extremely rare association that can cause manifestations of ischemic heart disease in patients. Distinguishing these cases and prompt diagnosis and treatment can prevent possible complications. In this current case, a 72-year-old man complaining of typical exertional dyspnea for 6 months was admitted to the hospital in December 2022. An echocardiogram was conducted and revealed apical hypertrophic cardiomyopathy. A coronary angiogram showed ectasia and slow flow pattern in the coronary artery without significant stenosis. The patient was diagnosed with hypertrophic cardiomyopathy associated with ectasia via electrocardiography, echocardiography, and coronary angiography. Medical treatment was started for the patient. The patient did not appear to suffer from dyspnea or other symptoms during the follow-up period.

18.
JACC Case Rep ; 18: 101910, 2023 Jul 19.
Artículo en Inglés | MEDLINE | ID: mdl-37545691

RESUMEN

Coronary artery ectasia (CAE) is a cause of juvenile myocardial infarction. The causes of CAE include arteriosclerosis, vasculitis such as Kawasaki disease, and genetic contribution. There are few reports about familial aggregation of CAE-related juvenile myocardial infarction. We report an unusual case of father-son juvenile myocardial infarction owing to CAE. (Level of Difficulty: Beginner.).

19.
Am J Cardiol ; 205: 63-68, 2023 10 15.
Artículo en Inglés | MEDLINE | ID: mdl-37586123

RESUMEN

Coronary artery ectasia (CAE) is defined as local or generalized aneurysmal dilatation of the coronary arteries. CAE likely represents an exaggerated form of excessive vascular wall remodeling in different clinical settings such as atherosclerosis, vasculitides, connective tissue disorders, hereditary collagen defects, bacterial infections, and congenital malformations. In the present case-control study, we investigated whether the incidental finding of CAE in patients who undergo coronary angiography is associated with presence of autoimmune reactivity. From 2019 to 2022, we identified all consecutive patients with CAE (n = 319) on elective or emergency coronary angiography (n = 7,458). We furthermore included 90 patients with nonectatic coronary arteries as a control group. Antinuclear antibody (ANA) titer was measured in both groups using the indirect immunofluorescence method from peripheral blood samples. The prevalence of CAE in our study cohort was 4.3%. Among patients with CAE (n = 319), presence of positive Antinuclear antibody (ANA) titer was identified in 128 patients (40%). Only 18 patients (20%) from the control group had positive ANA titer. There was a statistically significant greater percentage of patients with positive ANA titer among patients with CAE than among controls (chi-square = 12.39; p <0.001), with an odds ratio of 2.68. Among patients with CAE, there is an increased prevalence of positive ANA titer, suggesting an underlying autoimmune disease. Screening for autoimmune reactivity could be a reasonable diagnostic strategy in patients who undergo coronary angiography with an incidental finding of coronary ectasia because the number needed to screen for positive ANA titer in this subgroup of patients is only 5.


Asunto(s)
Enfermedades Autoinmunes , Aneurisma Coronario , Enfermedad de la Arteria Coronaria , Humanos , Dilatación Patológica/epidemiología , Vasos Coronarios/diagnóstico por imagen , Estudios de Casos y Controles , Anticuerpos Antinucleares , Estudios Transversales , Aneurisma Coronario/epidemiología , Angiografía Coronaria/métodos , Enfermedades Autoinmunes/complicaciones , Enfermedades Autoinmunes/diagnóstico , Enfermedades Autoinmunes/epidemiología , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/epidemiología
20.
Tohoku J Exp Med ; 261(2): 165-171, 2023 Oct 24.
Artículo en Inglés | MEDLINE | ID: mdl-37558418

RESUMEN

Coronary artery ectasia (CAE) is defined as segmental dilatation with a diameter of 1.5-fold greater than that of an adjacent normal segment. Whether CAE is a unique clinical finding or results from other clinical entities remains to be determined. The purpose of the study was to investigate the prevalence, and clinical and angiographic characteristics of CAE in patients with coronary artery disease (CAD). Among the 8,845 coronary angiograms reviewed between the years 2014 and 2022, 142 patients had CAE yielding a detection rate of 4.9% among 2,870 CAD angiograms, and 28 patients had isolated CAE showing a detection rate of 0.32% (28/8,845) among total coronary angiography procedures. Overall, the incidence of CAE was 1.92% (170/8,845). The most commonly affected coronary artery by ectasia was the right coronary artery (RCA) (46.28%) among CAE coexisting with CAD cohort. The proportion of obesity, family history of CAD, and the proportion of hyperlipidemia in CAD patients who had ectasia were significantly higher than that in CAD patients who did not have ectasia (P < 0.05). In conclusion, CAE is an uncommon finding in coronary angiography, most commonly affecting the RCA. The obesity, family history of CAD, and the coexistence of hyperlipidemia were independent variables associated with CAE in CAD patients.


Asunto(s)
Aneurisma Coronario , Enfermedad de la Arteria Coronaria , Hiperlipidemias , Humanos , Enfermedad de la Arteria Coronaria/complicaciones , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/epidemiología , Estudios Retrospectivos , Dilatación Patológica/complicaciones , Dilatación Patológica/diagnóstico por imagen , Dilatación Patológica/epidemiología , Vasos Coronarios/diagnóstico por imagen , Prevalencia , Angiografía Coronaria/métodos , Obesidad
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