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Jeon H, Cho JM, Yang IH, Kim N, Park CB. Coronary artery ectasia presenting as acute coronary syndrome and misinterpreted as coronary artery perforation: Case report. Medicine (Baltimore) 2025; 104:e42330. [PMID: 40324275 PMCID: PMC12055177 DOI: 10.1097/md.0000000000042330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2024] [Accepted: 04/15/2025] [Indexed: 05/07/2025] Open
Abstract
RATIONALE Coronary artery ectasia (CAE), characterized by diffuse dilation, can be associated with total thrombotic occlusion, leading to acute coronary syndrome. In such cases, distal vessel morphology can be highly unpredictable, potentially causing confusion during percutaneous coronary intervention (PCI). PATIENT CONCERNS A 47-year-old man presented with sudden chest pain. Acute coronary syndrome was suspected based on symptom and elevated troponin I levels. DIAGNOSES Coronary angiography revealed diffuse CAE and total occlusion of mid-left circumflex artery. INTERVENTIONS Due to the large thrombus, aspiration thrombectomy, intracoronary abciximab, and repeated balloon angioplasty were performed. After these procedures, there was absence of flow beyond the lesion, and huge extravasation around the vessel, resembling a coronary artery perforation. Considering various factors, we concluded it was not a perforation and subsequently performed intravascular ultrasound-guided PCI on the ectatic culprit vessel. After successful PCI, he was discharged on aspirin and clopidogrel. Due to heartburn, dual antiplatelet therapy was de-escalated to clopidogrel monotherapy after 6 months. OUTCOMES During the follow-up, he remained stable, and a 9-month coronary angiography confirmed patent stent without lesion progression. LESSONS Stagnant flow in dilated vessels can cause local dye deposition, which may resemble procedure-induced perforation or dissection, necessitating heightened caution during PCI. Intravascular ultrasound is valuable for accurate assessment of lesions in CAE. Thrombectomy and glycoprotein IIb/IIIa inhibitors would be considered to manage high thrombus burden. Due to its diverse clinical presentations, CAE requires an individualized strategy, and can also be treated with simple PCI followed by dual antiplatelet therapy.
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Affiliation(s)
- Hongki Jeon
- Department of Internal Medicine, Division of Cardiology, Kyung Hee University, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| | - Jin-Man Cho
- Department of Internal Medicine, Division of Cardiology, Kyung Hee University, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| | - In-Ho Yang
- Department of Internal Medicine, Division of Cardiology, Kyung Hee University, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| | - Narae Kim
- Department of Internal Medicine, Division of Cardiology, Kyung Hee University, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| | - Chang-Bum Park
- Department of Internal Medicine, Division of Cardiology, Kyung Hee University, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
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2
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Aslan V, Terzi S, Yeşilcimen K. Paraoxonase 1 Enzyme Activity in Patients With Isolated Coronary Artery Ectasia. Cureus 2025; 17:e83703. [PMID: 40342642 PMCID: PMC12059976 DOI: 10.7759/cureus.83703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2025] [Indexed: 05/11/2025] Open
Abstract
OBJECTIVE Paraoxonase 1 (PON1) is an organophosphate ester hydrolase associated with high-density lipoprotein (HDL). The recently emphasized function of PON1 activity is its antiatherogenic activity. PON1 is always found together with HDL in plasma, and PON1 is responsible for the protective effect of HDL against low-density lipoprotein (LDL) oxidation. Considering this role in cardiovascular diseases and its antioxidant properties, PON1 activity may be a valuable biomarker in predicting coronary artery ectasia (CAE), whose pathogenesis has not yet been fully elucidated. The aim was to reveal the relationship between PON1 activity and isolated CAE. METHOD This prospective case-control study's population comprises 5240 patients who underwent coronary angiography between December 2009 and April 30, 2010. Thirty patients with isolated CAE (Group CAE) and 25 volunteers with normal coronary arteries (Group Control) who met the inclusion criteria were included in the study. The sociodemographic, clinical, and anatomical characteristics and lipid profiles of the patients were analyzed. Groups CAE and control were compared in terms of PON1 activity levels. RESULTS There was no significant difference between Group CAE (n=30) and Group Control (n=25) in terms of sociodemographic and clinical characteristics (p>0.05). There was ectasia in a single coronary artery in 19 patients (63.3%). The right coronary artery (RCA) was ectasian in 17 patients (38.6%) and was the most affected vessel. According to the Markis classification, the most common type of ectasia was type IV ectasia, which was seen in 14 patients (46.7%). When lipid profiles were compared, no difference was observed between the groups. PON1 activity levels were significantly lower in the CAE group than in the control group (Group CAE=127.5 U/L; Group Control=177.0 U/L; p<0.001). CONCLUSIONS This study's findings suggest a significant correlation between low PON1 activity levels and the development of isolated CAE, suggesting that PON1 activity may play a potential role in the pathophysiology of CAE. Based on the association demonstrated between isolated CAE and PON1 activity in our study, future research may investigate the potential use of PON1 as a biomarker.
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Affiliation(s)
- Vedat Aslan
- Department of Cardiology, School of Medicine, Istinye University, Istanbul, TUR
| | - Sait Terzi
- Department of Cardiology, Dr. Siyami Ersek Chest Cardiovascular Surgery Training and Research Hospital, Istanbul, TUR
| | - Kemal Yeşilcimen
- Department of Cardiology, Dr. Siyami Ersek Chest Cardiovascular Surgery Training and Research Hospital, Istanbul, TUR
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3
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Woźniak P, Iwańczyk S, Błaszyk M, Stępień K, Lesiak M, Mularek-Kubzdela T, Araszkiewicz A. Coronary Artery Aneurysm or Ectasia as a Form of Coronary Artery Remodeling: Etiology, Pathogenesis, Diagnostics, Complications, and Treatment. Biomedicines 2024; 12:1984. [PMID: 39335497 PMCID: PMC11428638 DOI: 10.3390/biomedicines12091984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Revised: 08/19/2024] [Accepted: 08/29/2024] [Indexed: 09/30/2024] Open
Abstract
Coronary artery aneurysm or ectasia (CAAE) is a term that includes both coronary artery ectasia (CAE) and coronary artery aneurysm (CAA), despite distinct phenotypes and definitions. This anomaly can be found in 0.15-5.3% of coronary angiography. CAE is a diffuse dilatation of the coronary artery at least 1.5 times wider than the diameter of the normal coronary artery in a patient with a length of over 20 mm or greater than one-third of the vessel. CAE can be further subdivided into diffuse and focal dilations by the number and the length of the dilated vessels. Histologically, it presents with extensive destruction of musculoelastic elements, marked degradation of collagen and elastic fibers, and disruption of the elastic lamina. Conversely, CAA is a focal lesion manifesting as focal dilatation, which can be fusiform (if the longitudinal diameter is greater than the transverse) or saccular (if the longitudinal diameter is smaller than the transverse). Giant CAA is defined as a 4-fold enlargement of the vessel diameter and is observed in only 0.02% of patients after coronary. An aneurysmal lesion can be either single or multiple. It can be either a congenital or acquired phenomenon. The pathophysiological mechanisms responsible for the formation of CAAE are not well understood. Atherosclerosis is the most common etiology of CAAE in adults, while Kawasaki disease is the most common in children. Other etiological factors include systemic connective tissue diseases, infectious diseases, vasculitis, congenital anomalies, genetic factors, and idiopathic CAA. Invasive assessment of CAAE is based on coronary angiography. Coronary computed tomography (CT) is a noninvasive method that enables accurate evaluation of aneurysm size and location. The most common complications are coronary spasm, local thrombosis, distal embolization, coronary artery rupture, and compression of adjacent structures by giant coronary aneurysms. The approach to each patient with CAAE should depend on the severity of symptoms, anatomical structure, size, and location of the aneurysm. Treatment methods should be carefully considered to avoid possible complications of CAAE. Simultaneously, we should not unnecessarily expose the patient to the risk of intervention or surgical treatment. Patients can be offered conservative or invasive treatment. However, there are still numerous controversies and ambiguities regarding the etiology, prognosis, and treatment of patients with coronary artery aneurysms. This study summarizes the current knowledge about this disease's etiology, pathogenesis, and management.
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Affiliation(s)
- Patrycja Woźniak
- 1st Department of Cardiology, Poznan University of Medical Sciences, Długa 1/2 Street, 61-848 Poznań, Poland
| | - Sylwia Iwańczyk
- 1st Department of Cardiology, Poznan University of Medical Sciences, Długa 1/2 Street, 61-848 Poznań, Poland
| | - Maciej Błaszyk
- Department of Radiology, Poznan University of Medical Sciences, 61-701 Poznań, Poland
| | - Konrad Stępień
- Department of Coronary Artery Disease and Heart Failure, Jagiellonian University Medical College, Prądnicka 80 Street, 31-202 Kraków, Poland
| | - Maciej Lesiak
- 1st Department of Cardiology, Poznan University of Medical Sciences, Długa 1/2 Street, 61-848 Poznań, Poland
| | - Tatiana Mularek-Kubzdela
- 1st Department of Cardiology, Poznan University of Medical Sciences, Długa 1/2 Street, 61-848 Poznań, Poland
| | - Aleksander Araszkiewicz
- 1st Department of Cardiology, Poznan University of Medical Sciences, Długa 1/2 Street, 61-848 Poznań, Poland
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Yang X, Zong Y, Zhang Z, Yin H, Zhang X, Miao Y, Xiao B. Risk factors and major adverse cardiovascular events of isolated coronary artery ectasia: An observational study. Medicine (Baltimore) 2024; 103:e38413. [PMID: 38847735 PMCID: PMC11155586 DOI: 10.1097/md.0000000000038413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 05/09/2024] [Indexed: 06/10/2024] Open
Abstract
To evaluate the cardiac index and major adverse cardiovascular events (MACE) events between isolated coronary artery ectasia (CAE) and control groups over 1 year period from diagnosis. A total of 18 patients who were diagnosed with isolated CAE in the Second Hospital of Hebei Medical University from December 2020 to December 2021 were included in CAE group. About 36 patients with non-obstructive coronary artery lesions were included in the control group. All patients in 2 groups completed dobutamine stress echocardiography (DSE) during hospitalization. The chamber size, wall thickness, left ventricular ejection fraction, and left ventricular diastolic function indicators (including E/A ratio, e', and E/e' ratio) were measured. MACE and all-cause death were measured during follow-up after discharge. Interventricular septum thickness (IVSd), left ventricular posterior wall (LVPW) thickness in diastole and E/e' in CAE group were significantly higher than control group (P < .05). No significant differences were found in prognosis including angina, myocardial ischemia (MI), patient readmission and cardiovascular death (P > .05). In CAE group, coronary angiography showed dilation of left anterior descending (LAD) in 1 case, left circumflex (LCX) in 3 cases and right coronary artery (RCA) in 14 cases. Multivariate logistic regression analysis showed that BMI and IVSd were independent risk factors for CAE. IVSd, LVPW thickness in diastole and E/e' in CAE group were significantly higher than control group. BMI and IVSd were independent risk factors for isolated CAE, and had a good predictive value for isolated CAE.
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Affiliation(s)
- Xiuchun Yang
- Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yijun Zong
- School of Nursing, Hebei University of Chinese Medicine, Shijiazhuang, China
| | - Zhentian Zhang
- Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Hongning Yin
- Department of Cardiac Ultrasound, the Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xuqian Zhang
- Department of Cardiac Ultrasound, the Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yajing Miao
- Department of Cardiac Ultrasound, the Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Bing Xiao
- Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang, China
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5
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Khalid N, Kumar S, Muskula P, Muhammad H, Helmy T. Coronary Artery Aneurysms and Acute Coronary Syndrome: An Interventionalist's Dilemma. Methodist Debakey Cardiovasc J 2024; 20:33-39. [PMID: 38855039 PMCID: PMC11160384 DOI: 10.14797/mdcvj.1343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 05/21/2024] [Indexed: 06/11/2024] Open
Abstract
We report three cases of coronary artery aneurysm (CAA) in adults who presented with acute coronary syndrome. Two of these patients did not have traditional coronary artery disease risk factors. Management of CAA poses a significant challenge to interventionalists. We discuss the etiologic mechanisms, risk factors, pathophysiology, and diagnosis using angiography, intravascular ultrasound, and coronary computed tomography. We also highlight management options, including medical therapy and catheter-based interventions such as stenting, coil embolization, stent-assisted coil embolization, and surgical exclusion.
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Affiliation(s)
| | | | - Preetham Muskula
- UT Health East Texas Heart and Vascular Institute, Tyler, Texas, US
| | | | - Tarek Helmy
- Louisiana State University Health, Shreveport, Louisiana, US
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6
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Toprak K, Kaplangoray M, Inanır M, Memioğlu T. How Effective is the Systemic Inflammatory Immune Index in the Etiopathogenesis of Isolated Coronary Artery Ectasia?Reply. Arq Bras Cardiol 2023; 120:e20230048. [PMID: 37729252 PMCID: PMC10519350 DOI: 10.36660/abc.20230048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/09/2023] [Accepted: 02/09/2023] [Indexed: 09/22/2023] Open
Affiliation(s)
- Kenan Toprak
- Harran UniversityDepartment of CardiologySanliurfaTurquiaHarran University - Department of Cardiology, Sanliurfa – Turquia
| | - Mustafa Kaplangoray
- Bilecik Şeyh Edebali Üniversitesi – CardiologyBilecikTurquiaBilecik Şeyh Edebali Üniversitesi – Cardiology, Bilecik – Turquia
| | - Mehmet Inanır
- Abant Izzet Baysal UniversityCardiology DepartmentBoluTurquiaAbant Izzet Baysal University - Cardiology Department, Bolu – Turquia
| | - Tolga Memioğlu
- Abant Izzet Baysal UniversityCardiology DepartmentBoluTurquiaAbant Izzet Baysal University - Cardiology Department, Bolu – Turquia
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7
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Liu RF, Gao XY, Liang SW, Zhao HQ. Antithrombotic treatment strategy for patients with coronary artery ectasia and acute myocardial infarction: A case report. World J Clin Cases 2022; 10:3936-3943. [PMID: 35647140 PMCID: PMC9100716 DOI: 10.12998/wjcc.v10.i12.3936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 01/19/2022] [Accepted: 03/06/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND There is no consensus on the antithrombotic treatment strategy for patients with coronary artery ectasia (CAE).
CASE SUMMARY This case reports the dynamic observation of a patient for 48 mo after a diagnosis of CAE with acute myocardial infarction (AMI). The first antithrombotic agents used were aspirin (100 mg/d) and clopidogrel (75 mg/d). During the sixth month of observation, a second AMI occurred involving the same culprit vessel; therefore, antithrombotic agents were changed to aspirin (100 mg/d) and ticagrelor (90 mg twice per day). Twelve months after the second AMI, an attempt to reduce the dosage ticagrelor failed; therefore the original dose was continued. The CAE was relatively stable during the following 4 years.
CONCLUSION This case indicates that a combination of aspirin and ticagrelor may be more effective for CAE patients with AMI than aspirin and clopidogrel.
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Affiliation(s)
- Rui-Feng Liu
- Department of Cardiology, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing 100050, China
| | - Xiang-Yu Gao
- Department of Cardiology, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing 100050, China
| | - Si-Wen Liang
- Department of Cardiology, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing 100050, China
| | - Hui-Qiang Zhao
- Department of Cardiology, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing 100050, China
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8
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Zalewska-Adamiec M, Kuzma L, Bachorzewska-Gajewska H, Dobrzycki S. Fractional Flow Reserve in the Diagnosis of Ischemic Heart Disease in a Patient with Coronary Artery Ectasia. Diagnostics (Basel) 2021; 12:diagnostics12010017. [PMID: 35054184 PMCID: PMC8774518 DOI: 10.3390/diagnostics12010017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 12/13/2021] [Accepted: 12/16/2021] [Indexed: 11/25/2022] Open
Abstract
Coronary artery ectasias (CAE) are diffuse dilatations of coronary artery segments with a diameter 1.5 times greater than the largest adjacent normal segment of the vessel. They are found in 0.3–5.0% of coronary angiography. Risk factors for CAE include atherosclerosis, previous percutaneous coronary interventions, arterial inflammation and connective tissue diseases. The diagnosis of CEA in a patient is a considerable diagnostic and therapeutic problem due to the unfavorable prognosis and the lack of guidelines. We present a case of a 69-year-old male patient with a history of retrosternal pain admitted to the clinic for the diagnosis of coronary artery disease. In coronary angiography, numerous ectases of the main coronary arteries and atherosclerotic lesions causing border stenosis of the left anterior descending (LAD), diagonal (2D) and marginal branch (OM). The heart team decided to assess the significance of the changes with the fractional flow reserve (FFR). The FFR was performed and haemodynamically insignificant stenoses of the ectatically dilated coronary arteries were found. The patient was qualified for conservative treatment.
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Affiliation(s)
| | - Lukasz Kuzma
- Department of Invasive Cardiology, Medical University of Bialystok, 15276 Bialystok, Poland
| | - Hanna Bachorzewska-Gajewska
- Department of Invasive Cardiology, Medical University of Bialystok, 15276 Bialystok, Poland
- Department of Clinical Medicine, Medical University of Bialystok, 24A Sklodowskiej-Curie St., 15276 Bialystok, Poland
| | - Slawomir Dobrzycki
- Department of Invasive Cardiology, Medical University of Bialystok, 15276 Bialystok, Poland
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9
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Cai Z, Wang Y, Li L, Wang H, Song C, Yin D, Song W, Dou K. Development and Validation of a Nomogram for Predicting the Risk of Adverse Cardiovascular Events in Patients with Coronary Artery Ectasia. J Cardiovasc Dev Dis 2021; 8:jcdd8120186. [PMID: 34940541 PMCID: PMC8708195 DOI: 10.3390/jcdd8120186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 11/30/2021] [Accepted: 12/09/2021] [Indexed: 12/25/2022] Open
Abstract
Coronary artery ectasia (CAE) is a rare finding and is associated with poor clinical outcomes. However, prognostic factors are not well studied and no prognostication tool is available. In a derivation set comprising 729 consecutive CAE patients between January 2009 and June 2014, a nomogram was developed using Cox regression. Total of 399 patients from July 2014 to December 2015 formed the validation set. The primary outcome was 5-year major adverse cardiovascular events (MACE), a component of cardiovascular death and nonfatal myocardial infarction. Besides the clinical factors, we used quantitative coronary angiography (QCA) and defined QCA classification of four types, according to max diameter (< or ≥5 mm) and max length ratio (ratio of lesion length to vessel length, < or ≥1/3) of the dilated lesion. A total of 27 cardiovascular deaths and 41 nonfatal myocardial infarctions occurred at 5-year follow-up. The nomogram effectively predicted 5-year MACE risk using predictors including age, prior PCI, high sensitivity C-reactive protein, N-terminal pro-brain natriuretic peptide, and QCA classification (area under curve [AUC] 0.75, 95% CI 0.68–0.82 in the derivation set; AUC 0.71, 95% CI 0.56–0.86 in the validation set). Patients were classified as high-risk if prognostic scores were ≥155 and the Kaplan–Meier curves were well separated (log-rank p < 0.001 in both sets). Calibration curve and Hosmer–Lemeshow test indicated similarity between predicted and actual 5-year MACE survival (p = 0.90 in the derivation and p = 0.47 in the validation set). This study developed and validated a simple-to-use method for assessing 5-year MACE risk in patients with CAE.
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Affiliation(s)
- Zhongxing Cai
- Cardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; (Z.C.); (H.W.); (C.S.); (D.Y.)
| | - Yintang Wang
- Department of Cardiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China;
| | - Luqi Li
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China;
| | - Haoyu Wang
- Cardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; (Z.C.); (H.W.); (C.S.); (D.Y.)
| | - Chenxi Song
- Cardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; (Z.C.); (H.W.); (C.S.); (D.Y.)
| | - Dong Yin
- Cardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; (Z.C.); (H.W.); (C.S.); (D.Y.)
| | - Weihua Song
- Cardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; (Z.C.); (H.W.); (C.S.); (D.Y.)
- Correspondence: (W.S.); (K.D.)
| | - Kefei Dou
- Cardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; (Z.C.); (H.W.); (C.S.); (D.Y.)
- Correspondence: (W.S.); (K.D.)
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10
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Wang X, Montero-Cabezas JM, Mandurino-Mirizzi A, Hirasawa K, Ajmone Marsan N, Knuuti J, Bax JJ, Delgado V. Prevalence and Long-term Outcomes of Patients with Coronary Artery Ectasia Presenting with Acute Myocardial Infarction. Am J Cardiol 2021; 156:9-15. [PMID: 34344511 DOI: 10.1016/j.amjcard.2021.06.037] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/11/2021] [Accepted: 06/15/2021] [Indexed: 12/11/2022]
Abstract
Coronary artery ectasia (CAE) is described in 5% of patients undergoing coronary angiography. Previous studies have shown controversial results regarding the prognostic impact of CAE. The prevalence and prognostic value of CAE in patients with acute myocardial infarction (AMI) remain unknown. In 4788 patients presenting with AMI referred for coronary angiography the presence of CAE (defined as dilation of a coronary segment with a diameter ≥1.5 times of the adjacent normal segment) was confirmed in 174 (3.6%) patients (age 62 ± 12 years; 81% male), and was present in the culprit vessel in 79.9%. Multivessel CAE was frequent (67%). CAE patients were more frequently male, had high thrombus burden and were treated more often with thrombectomy and less often was stent implantation. Markis I was the most frequent angiographic phenotype (43%). During a median follow-up of 4 years (1-7), 1243 patients (26%) experienced a major adverse cardiovascular event (MACE): 282 (6%) died from a cardiac cause, 358 (8%) had a myocardial infarction, 945 (20%) underwent coronary revascularization and 58 (1%) presented with a stroke. Patients with CAE showed higher rates of MACE as compared to those without CAE (36.8% versus 25.6%; p <0.001). On multivariable analysis, CAE was associated with MACE (HR 1.597; 95% CI 1.238-2.060; p <0.001) after adjusting for risk factors, type of AMI and number of narrowed coronary arteries. In conclusion, the prevalence of CAE in patients presenting with AMI is relatively low but was independently associated with an increased risk of MACE at follow-up.
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Affiliation(s)
- Xu Wang
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing, China
| | | | - Alessandro Mandurino-Mirizzi
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; Division of Cardiology, Foundation IRCCS Policlinico San Matteo, Pavia, Italy
| | - Kensuke Hirasawa
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Nina Ajmone Marsan
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Juhani Knuuti
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; Heart Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Jeroen J Bax
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; Heart Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Victoria Delgado
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
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11
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Matta AG, Yaacoub N, Nader V, Moussallem N, Carrie D, Roncalli J. Coronary artery aneurysm: A review. World J Cardiol 2021; 13:446-455. [PMID: 34621489 PMCID: PMC8462041 DOI: 10.4330/wjc.v13.i9.446] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 06/09/2021] [Accepted: 07/29/2021] [Indexed: 02/06/2023] Open
Abstract
Coronary artery aneurysm (CAA) is a clinical entity defined by a focal enlargement of the coronary artery exceeding the 1.5-fold diameter of the adjacent normal segment. Atherosclerosis is the main cause in adults and Kawasaki disease in children. CAA is a silent progressive disorder incidentally detected by coronary angiography, but it may end with fatal complications such as rupture, compression of adjacent cardiopulmonary structures, thrombus formation and distal embolization. The pathophysiological mechanisms are not well understood. Atherosclerosis, proteolytic imbalance and inflammatory reaction are involved in aneurysmal formation. Data from previously published studies are scarce and controversial, thereby the management of CAA is individualized depending on clinical presentation, CAA characteristics, patient profile and physician experience. Multiple therapeutic approaches including medical treatment, covered stent angioplasty, coil insertion and surgery were described. Herein, we provide an up-to-date systematic review on the pathophysiology, complications and management of CAA.
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Affiliation(s)
- Anthony Georges Matta
- Department of Cardiology, Toulouse University Hospital, Rangueil, Toulouse 31400, France
| | - Nabil Yaacoub
- Faculty of Medicine, Holy Spirit University of Kaslik, Jounieh 961, Lebanon
| | - Vanessa Nader
- Department of Cardiology, Toulouse University Hospital, Rangueil, Toulouse 31400, France
| | - Nicolas Moussallem
- Division of Cardiology, Faculty of Medicine, Holy Spirit University of Kaslik, Jounieh 961, Lebanon
| | - Didier Carrie
- Department of Cardiology, University Hospital Rangueil, Toulouse 31059, France
| | - Jerome Roncalli
- Department of Cardiology, University Hospital of Toulouse/Institute Cardiomet, Toulouse 31400, France.
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12
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Amirzadegan A, Sadre-Bafghi SA, Ghodsi S, Soleimani H, Mohebi M, Nematipour E, Haji-Zeinali AM, Salarifar M, Pourhosseini H, Nozari Y, Tajdini M, Aghajani H, Alidoosti M, Jenab Y, Omidi N, Jalali A, Hosseini Z. One-Year Outcome of Patients with Coronary Artery Ectasia Undergoing Percutaneous Coronary Intervention: Clinical Implications and Question Marks. J Tehran Heart Cent 2021; 15:171-177. [PMID: 34178086 PMCID: PMC8217191 DOI: 10.18502/jthc.v15i4.5943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: Coronary artery ectasia (CAE) is a rare condition with unclear pathophysiology, optimal treatment, and prognosis. We aimed to determine the prognostic implications of CAE following coronary angioplasty. Methods: We conducted a retrospective cohort study on 385 patients, including 87 subjects with CAE, who underwent percutaneous coronary intervention (PCI). Major adverse cardiovascular events (MACE) were considered to consist of mortality, nonfatal myocardial infarction (MI), repeated revascularization, and stroke. Results: The mean age of the participants was 57.31±6.70 years. Multivariate regression analysis revealed that patients with diabetes, ST-segment–elevation MI at presentation, and high thrombus grades were more likely to have suboptimal post-PCI thrombolysis in myocardial infarction (TIMI) flow. However, CAE was not a predictor of a decreased TIMI flow (OR: 1.46, 95% CI: 0.78–8.32; P=0.391). The Cox-regression model showed that CAE, the body mass index, and a family history of MI were risk factors for MACE, while short lesion lengths (<20 vs >20 mm) had an inverse relationship. The adjusted hazard ratio (HR) for the prediction of MACE in the presence of CAE was 1.65 (95% CI: 1.08–4.78; P=0.391). All-cause mortality (HR: 1.69, 95% CI: 0.12–3.81; P=0.830) and nonfatal MI (HR: 1.03, 95% CI: 0.72–4.21; P=0.341) occurred similarly in the CAE and non-CAE groups. Conversely, CAE increased urgent repeat revascularization (HR: 2.40; 95% CI: 1.13–5.86; P=0.013). Conclusion: Although CAE had no substantial short-term prognostic effects on post-PCI TIMI flow, considerable concerns regarding adverse outcomes emerged during our extended follow-up. Stringent follow-ups of these patients should be underscored due to the high likelihood of urgent revascularization.
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Affiliation(s)
| | | | - Saeed Ghodsi
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mehrnaz Mohebi
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ebrahim Nematipour
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mojtaba Salarifar
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Yones Nozari
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Masih Tajdini
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hassan Aghajani
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Alidoosti
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Yaser Jenab
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Omidi
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Jalali
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Hosseini
- Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
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13
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Pham V, Hemptinne QD, Grinda JM, Duboc D, Varenne O, Picard F. Giant coronary aneurysms, from diagnosis to treatment: A literature review. Arch Cardiovasc Dis 2020; 113:59-69. [DOI: 10.1016/j.acvd.2019.10.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 10/17/2019] [Accepted: 10/23/2019] [Indexed: 12/26/2022]
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14
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Gunasekaran P, Stanojevic D, Drees T, Fritzlen J, Haghnegahdar M, McCullough M, Barua R, Mehta A, Hockstad E, Wiley M, Earnest M, Tadros P, Genton R, Gupta K. Prognostic significance, angiographic characteristics and impact of antithrombotic and anticoagulant therapy on outcomes in high versus low grade coronary artery ectasia: A long-term follow-up study. Catheter Cardiovasc Interv 2018; 93:1219-1227. [DOI: 10.1002/ccd.27929] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Accepted: 09/23/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Prasad Gunasekaran
- Division of Cardiovascular Diseases; University of Kansas Medical Center; Kansas City Kansas
| | - Dusan Stanojevic
- Division of Cardiovascular Diseases; University of Kansas Medical Center; Kansas City Kansas
| | - Taylor Drees
- Division of Cardiovascular Diseases; University of Kansas Medical Center; Kansas City Kansas
| | - John Fritzlen
- Division of Cardiovascular Diseases; University of Kansas Medical Center; Kansas City Kansas
| | - Megan Haghnegahdar
- Division of Cardiovascular Diseases; University of Kansas Medical Center; Kansas City Kansas
| | - Matthew McCullough
- Division of Cardiovascular Diseases; University of Kansas Medical Center; Kansas City Kansas
| | - Rajat Barua
- Division of Cardiology; Kansas City Veterans Affairs Medical Center; Kansas City Missouri
| | - Ashwani Mehta
- Division of Cardiovascular Diseases; University of Kansas Medical Center; Kansas City Kansas
| | - Eric Hockstad
- Division of Cardiovascular Diseases; University of Kansas Medical Center; Kansas City Kansas
| | - Mark Wiley
- Division of Cardiovascular Diseases; University of Kansas Medical Center; Kansas City Kansas
| | - Matthew Earnest
- Division of Cardiovascular Diseases; University of Kansas Medical Center; Kansas City Kansas
| | - Peter Tadros
- Division of Cardiovascular Diseases; University of Kansas Medical Center; Kansas City Kansas
| | - Randall Genton
- Division of Cardiovascular Diseases; University of Kansas Medical Center; Kansas City Kansas
| | - Kamal Gupta
- Division of Cardiovascular Diseases; University of Kansas Medical Center; Kansas City Kansas
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15
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Kawsara A, Núñez Gil IJ, Alqahtani F, Moreland J, Rihal CS, Alkhouli M. Management of Coronary Artery Aneurysms. JACC Cardiovasc Interv 2018; 11:1211-1223. [DOI: 10.1016/j.jcin.2018.02.041] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 01/07/2018] [Accepted: 02/20/2018] [Indexed: 01/11/2023]
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16
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Liang S, Zhang Y, Gao X, Zhao H, Di B, Sheng Q, Liu R. Is Coronary Artery Ectasia a Thrombotic Disease? Angiology 2018; 70:62-68. [PMID: 29929375 DOI: 10.1177/0003319718782807] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Coronary artery ectasia (CAE) is a rare disease and a substantial portion of patients with CAE are first diagnosed with acute myocardial infarction (AMI). The question was raised if CAE was a kind of thrombotic disease. We assessed a consecutive series of 119 patients with CAE including 32 patients with AMI (CAE + AMI group) and 87 patients without AMI (CAE group). During the same period, 90 patients with coronary heart disease, 90 patients with normal coronary arteries (control), and 120 AMI patients without CAE (AMI group) were randomly selected and evaluated. Both current and previous AMI prevalence rates in the CAE population were higher than the AMI rate for the other patients undergoing coronary angiograms; the mean platelet volume and fibrinogen were increased in the CAE + AMI and CAE groups. For patients with CAE with AMI, most of the thrombotic lesions were in the ectasia site. After dividing the patients with CAE into with and without antiplatelet treatment groups before admission, the AMI rate was lower in the antiplatelet group. Platelets may participate in the thrombotic process in CAE. Antiplatelet treatment may decrease the AMI rate of patients with CAE.
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Affiliation(s)
- Siwen Liang
- 1 Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yue Zhang
- 1 Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xiangyu Gao
- 1 Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Huiqiang Zhao
- 1 Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Beibing Di
- 1 Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Qianqian Sheng
- 1 Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Ruifeng Liu
- 1 Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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17
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Doi T, Kataoka Y, Noguchi T, Shibata T, Nakashima T, Kawakami S, Nakao K, Fujino M, Nagai T, Kanaya T, Tahara Y, Asaumi Y, Tsuda E, Nakai M, Nishimura K, Anzai T, Kusano K, Shimokawa H, Goto Y, Yasuda S. Coronary Artery Ectasia Predicts Future Cardiac Events in Patients With Acute Myocardial Infarction. Arterioscler Thromb Vasc Biol 2017; 37:2350-2355. [DOI: 10.1161/atvbaha.117.309683] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 09/25/2017] [Indexed: 12/23/2022]
Abstract
Objective—
Coronary artery ectasia (CAE) is an infrequently observed vascular phenotype characterized by abnormal vessel dilatation and disturbed coronary flow, which potentially promote thrombogenicity and inflammatory reactions. However, whether or not CAE influences cardiovascular outcomes remains unknown.
Approach and Results—
We investigated major adverse cardiac events (MACE; defined as cardiac death and nonfatal myocardial infarction [MI]) in 1698 patients with acute MI. The occurrence of MACE was compared in patients with and without CAE. CAE was identified in 3.0% of study subjects. During the 49-month observation period, CAE was associated with 3.25-, 2.71-, and 4.92-fold greater likelihoods of experiencing MACE (95% confidence interval [CI], 1.88–5.66;
P
<0.001), cardiac death (95% CI, 1.37–5.37;
P
=0.004), and nonfatal MI (95% CI, 2.20–11.0;
P
<0.001), respectively. These cardiac risks of CAE were consistently observed in a multivariate Cox proportional hazards model (MACE: hazard ratio, 4.94; 95% CI, 2.36–10.4;
P
<0.001) and in a propensity score–matched cohort (MACE: hazard ratio, 8.98; 95% CI, 1.14–71.0;
P
=0.03). Despite having a higher risk of CAE-related cardiac events, patients with CAE receiving anticoagulation therapy who achieved an optimal percent time in target therapeutic range, defined as ≥60%, did not experience the occurrence of MACE (
P
=0.03 versus patients with percent time in target therapeutic range <60% or without anticoagulation therapy).
Conclusions—
The presence of CAE predicted future cardiac events in patients with acute MI. Our findings suggest that acute MI patients with CAE are a high-risk subset who might benefit from a pharmacological approach to controlling the coagulation cascade.
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Affiliation(s)
- Takahito Doi
- From the Department of Cardiovascular Medicine (T.D., Y.K., T. Noguchi, T. Nakashima, S.K., K. Nakao, M.F., T. Nagai, T.K., Y.T., Y.A., T.A., K.K., Y.G., S.Y.), Department of Pediatric Cardiology (E.T.), and Department of Statistics and Data Analysis, Center for Cerebral and Cardiovascular Disease Information (M.N., K.N.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Advanced Cardiovascular Medicine (T.D., S.Y.) and Department of Cardiovascular Medicine (H.S.), Tohoku
| | - Yu Kataoka
- From the Department of Cardiovascular Medicine (T.D., Y.K., T. Noguchi, T. Nakashima, S.K., K. Nakao, M.F., T. Nagai, T.K., Y.T., Y.A., T.A., K.K., Y.G., S.Y.), Department of Pediatric Cardiology (E.T.), and Department of Statistics and Data Analysis, Center for Cerebral and Cardiovascular Disease Information (M.N., K.N.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Advanced Cardiovascular Medicine (T.D., S.Y.) and Department of Cardiovascular Medicine (H.S.), Tohoku
| | - Teruo Noguchi
- From the Department of Cardiovascular Medicine (T.D., Y.K., T. Noguchi, T. Nakashima, S.K., K. Nakao, M.F., T. Nagai, T.K., Y.T., Y.A., T.A., K.K., Y.G., S.Y.), Department of Pediatric Cardiology (E.T.), and Department of Statistics and Data Analysis, Center for Cerebral and Cardiovascular Disease Information (M.N., K.N.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Advanced Cardiovascular Medicine (T.D., S.Y.) and Department of Cardiovascular Medicine (H.S.), Tohoku
| | - Tatsuhiro Shibata
- From the Department of Cardiovascular Medicine (T.D., Y.K., T. Noguchi, T. Nakashima, S.K., K. Nakao, M.F., T. Nagai, T.K., Y.T., Y.A., T.A., K.K., Y.G., S.Y.), Department of Pediatric Cardiology (E.T.), and Department of Statistics and Data Analysis, Center for Cerebral and Cardiovascular Disease Information (M.N., K.N.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Advanced Cardiovascular Medicine (T.D., S.Y.) and Department of Cardiovascular Medicine (H.S.), Tohoku
| | - Takahiro Nakashima
- From the Department of Cardiovascular Medicine (T.D., Y.K., T. Noguchi, T. Nakashima, S.K., K. Nakao, M.F., T. Nagai, T.K., Y.T., Y.A., T.A., K.K., Y.G., S.Y.), Department of Pediatric Cardiology (E.T.), and Department of Statistics and Data Analysis, Center for Cerebral and Cardiovascular Disease Information (M.N., K.N.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Advanced Cardiovascular Medicine (T.D., S.Y.) and Department of Cardiovascular Medicine (H.S.), Tohoku
| | - Shoji Kawakami
- From the Department of Cardiovascular Medicine (T.D., Y.K., T. Noguchi, T. Nakashima, S.K., K. Nakao, M.F., T. Nagai, T.K., Y.T., Y.A., T.A., K.K., Y.G., S.Y.), Department of Pediatric Cardiology (E.T.), and Department of Statistics and Data Analysis, Center for Cerebral and Cardiovascular Disease Information (M.N., K.N.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Advanced Cardiovascular Medicine (T.D., S.Y.) and Department of Cardiovascular Medicine (H.S.), Tohoku
| | - Kazuhiro Nakao
- From the Department of Cardiovascular Medicine (T.D., Y.K., T. Noguchi, T. Nakashima, S.K., K. Nakao, M.F., T. Nagai, T.K., Y.T., Y.A., T.A., K.K., Y.G., S.Y.), Department of Pediatric Cardiology (E.T.), and Department of Statistics and Data Analysis, Center for Cerebral and Cardiovascular Disease Information (M.N., K.N.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Advanced Cardiovascular Medicine (T.D., S.Y.) and Department of Cardiovascular Medicine (H.S.), Tohoku
| | - Masashi Fujino
- From the Department of Cardiovascular Medicine (T.D., Y.K., T. Noguchi, T. Nakashima, S.K., K. Nakao, M.F., T. Nagai, T.K., Y.T., Y.A., T.A., K.K., Y.G., S.Y.), Department of Pediatric Cardiology (E.T.), and Department of Statistics and Data Analysis, Center for Cerebral and Cardiovascular Disease Information (M.N., K.N.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Advanced Cardiovascular Medicine (T.D., S.Y.) and Department of Cardiovascular Medicine (H.S.), Tohoku
| | - Toshiyuki Nagai
- From the Department of Cardiovascular Medicine (T.D., Y.K., T. Noguchi, T. Nakashima, S.K., K. Nakao, M.F., T. Nagai, T.K., Y.T., Y.A., T.A., K.K., Y.G., S.Y.), Department of Pediatric Cardiology (E.T.), and Department of Statistics and Data Analysis, Center for Cerebral and Cardiovascular Disease Information (M.N., K.N.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Advanced Cardiovascular Medicine (T.D., S.Y.) and Department of Cardiovascular Medicine (H.S.), Tohoku
| | - Tomoaki Kanaya
- From the Department of Cardiovascular Medicine (T.D., Y.K., T. Noguchi, T. Nakashima, S.K., K. Nakao, M.F., T. Nagai, T.K., Y.T., Y.A., T.A., K.K., Y.G., S.Y.), Department of Pediatric Cardiology (E.T.), and Department of Statistics and Data Analysis, Center for Cerebral and Cardiovascular Disease Information (M.N., K.N.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Advanced Cardiovascular Medicine (T.D., S.Y.) and Department of Cardiovascular Medicine (H.S.), Tohoku
| | - Yoshio Tahara
- From the Department of Cardiovascular Medicine (T.D., Y.K., T. Noguchi, T. Nakashima, S.K., K. Nakao, M.F., T. Nagai, T.K., Y.T., Y.A., T.A., K.K., Y.G., S.Y.), Department of Pediatric Cardiology (E.T.), and Department of Statistics and Data Analysis, Center for Cerebral and Cardiovascular Disease Information (M.N., K.N.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Advanced Cardiovascular Medicine (T.D., S.Y.) and Department of Cardiovascular Medicine (H.S.), Tohoku
| | - Yasuhide Asaumi
- From the Department of Cardiovascular Medicine (T.D., Y.K., T. Noguchi, T. Nakashima, S.K., K. Nakao, M.F., T. Nagai, T.K., Y.T., Y.A., T.A., K.K., Y.G., S.Y.), Department of Pediatric Cardiology (E.T.), and Department of Statistics and Data Analysis, Center for Cerebral and Cardiovascular Disease Information (M.N., K.N.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Advanced Cardiovascular Medicine (T.D., S.Y.) and Department of Cardiovascular Medicine (H.S.), Tohoku
| | - Etsuko Tsuda
- From the Department of Cardiovascular Medicine (T.D., Y.K., T. Noguchi, T. Nakashima, S.K., K. Nakao, M.F., T. Nagai, T.K., Y.T., Y.A., T.A., K.K., Y.G., S.Y.), Department of Pediatric Cardiology (E.T.), and Department of Statistics and Data Analysis, Center for Cerebral and Cardiovascular Disease Information (M.N., K.N.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Advanced Cardiovascular Medicine (T.D., S.Y.) and Department of Cardiovascular Medicine (H.S.), Tohoku
| | - Michikazu Nakai
- From the Department of Cardiovascular Medicine (T.D., Y.K., T. Noguchi, T. Nakashima, S.K., K. Nakao, M.F., T. Nagai, T.K., Y.T., Y.A., T.A., K.K., Y.G., S.Y.), Department of Pediatric Cardiology (E.T.), and Department of Statistics and Data Analysis, Center for Cerebral and Cardiovascular Disease Information (M.N., K.N.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Advanced Cardiovascular Medicine (T.D., S.Y.) and Department of Cardiovascular Medicine (H.S.), Tohoku
| | - Kunihiro Nishimura
- From the Department of Cardiovascular Medicine (T.D., Y.K., T. Noguchi, T. Nakashima, S.K., K. Nakao, M.F., T. Nagai, T.K., Y.T., Y.A., T.A., K.K., Y.G., S.Y.), Department of Pediatric Cardiology (E.T.), and Department of Statistics and Data Analysis, Center for Cerebral and Cardiovascular Disease Information (M.N., K.N.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Advanced Cardiovascular Medicine (T.D., S.Y.) and Department of Cardiovascular Medicine (H.S.), Tohoku
| | - Toshihisa Anzai
- From the Department of Cardiovascular Medicine (T.D., Y.K., T. Noguchi, T. Nakashima, S.K., K. Nakao, M.F., T. Nagai, T.K., Y.T., Y.A., T.A., K.K., Y.G., S.Y.), Department of Pediatric Cardiology (E.T.), and Department of Statistics and Data Analysis, Center for Cerebral and Cardiovascular Disease Information (M.N., K.N.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Advanced Cardiovascular Medicine (T.D., S.Y.) and Department of Cardiovascular Medicine (H.S.), Tohoku
| | - Kengo Kusano
- From the Department of Cardiovascular Medicine (T.D., Y.K., T. Noguchi, T. Nakashima, S.K., K. Nakao, M.F., T. Nagai, T.K., Y.T., Y.A., T.A., K.K., Y.G., S.Y.), Department of Pediatric Cardiology (E.T.), and Department of Statistics and Data Analysis, Center for Cerebral and Cardiovascular Disease Information (M.N., K.N.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Advanced Cardiovascular Medicine (T.D., S.Y.) and Department of Cardiovascular Medicine (H.S.), Tohoku
| | - Hiroaki Shimokawa
- From the Department of Cardiovascular Medicine (T.D., Y.K., T. Noguchi, T. Nakashima, S.K., K. Nakao, M.F., T. Nagai, T.K., Y.T., Y.A., T.A., K.K., Y.G., S.Y.), Department of Pediatric Cardiology (E.T.), and Department of Statistics and Data Analysis, Center for Cerebral and Cardiovascular Disease Information (M.N., K.N.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Advanced Cardiovascular Medicine (T.D., S.Y.) and Department of Cardiovascular Medicine (H.S.), Tohoku
| | - Yoichi Goto
- From the Department of Cardiovascular Medicine (T.D., Y.K., T. Noguchi, T. Nakashima, S.K., K. Nakao, M.F., T. Nagai, T.K., Y.T., Y.A., T.A., K.K., Y.G., S.Y.), Department of Pediatric Cardiology (E.T.), and Department of Statistics and Data Analysis, Center for Cerebral and Cardiovascular Disease Information (M.N., K.N.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Advanced Cardiovascular Medicine (T.D., S.Y.) and Department of Cardiovascular Medicine (H.S.), Tohoku
| | - Satoshi Yasuda
- From the Department of Cardiovascular Medicine (T.D., Y.K., T. Noguchi, T. Nakashima, S.K., K. Nakao, M.F., T. Nagai, T.K., Y.T., Y.A., T.A., K.K., Y.G., S.Y.), Department of Pediatric Cardiology (E.T.), and Department of Statistics and Data Analysis, Center for Cerebral and Cardiovascular Disease Information (M.N., K.N.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Advanced Cardiovascular Medicine (T.D., S.Y.) and Department of Cardiovascular Medicine (H.S.), Tohoku
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18
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Wang Y, Zhang Y, Zhu CG, Guo YL, Huang QJ, Wu NQ, Gao Y, Qing P, Liu G, Dong Q, Li JJ. Big endothelin-1 level is a useful marker for predicting the presence of isolated coronary artery ectasia. Biomarkers 2017; 22:331-336. [PMID: 27885846 DOI: 10.1080/1354750x.2016.1265001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 10/25/2016] [Accepted: 11/06/2016] [Indexed: 01/23/2023]
Abstract
CONTEXT Endothelin-1(ET-1) has been implicated in coronary artery disease (CAD) and may be associated with coronary artery ectasia (CAE). OBJECTIVE To clarify the relationship between big ET-1 and isolated CAE. METHODS We measured big ET-1 with ELISA in 216 patients (CAE, n = 72; CAD, n = 72; normal, n = 72) and evaluated the link with isolated CAE. RESULTS The level of plasma big ET-1 was significantly higher in patients with isolated CAE (p < 0.001). Big ET-1 was strongly and independently associated with CAE by multivariate analysis (OR 95%CI: 1.026 (1.018-1.034), p = 0.000). CONCLUSIONS Big ET-1 may be a useful predictor for the presence of isolated CAE.
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Affiliation(s)
- Yao Wang
- a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China
| | - Yan Zhang
- a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China
| | - Cheng-Gang Zhu
- a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China
| | - Yuan-Lin Guo
- a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China
| | - Qiao-Juan Huang
- a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China
| | - Na-Qiong Wu
- a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China
| | - Ying Gao
- a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China
| | - Ping Qing
- a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China
| | - Geng Liu
- a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China
| | - Qian Dong
- a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China
| | - Jian-Jun Li
- a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China
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19
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Ozturk C, Balta S, Demir M, Yildirim AO, Unlu M, Arslan Z, Demirkol S, Celik T. The relation between coronary artery ectasia and psychological-environmental factors. J Saudi Heart Assoc 2016; 28:127-8. [PMID: 27053905 PMCID: PMC4803758 DOI: 10.1016/j.jsha.2015.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 12/23/2015] [Indexed: 10/27/2022] Open
Affiliation(s)
- Cengiz Ozturk
- Department of Cardiology, Gulhane Medical Faculty, Ankara, aTurkey
| | - Sevket Balta
- Department of Cardiology, Gulhane Medical Faculty, Ankara, aTurkey
| | - Mustafa Demir
- Department of Cardiology, Gulhane Medical Faculty, Ankara, aTurkey
| | | | - Murat Unlu
- Department of Cardiology, Gulhane Medical Faculty, Ankara, aTurkey
| | - Zekeriya Arslan
- Department of Cardiology, Ankara Mevki Military Hospital, Ankara, bTurkey
| | - Sait Demirkol
- Department of Cardiology, Gulhane Medical Faculty, Ankara, aTurkey
| | - Turgay Celik
- Department of Cardiology, Gulhane Medical Faculty, Ankara, aTurkey
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