Coronary artery ectasia: Clinical and angiographical evaluation [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2008; 36(8): 530-535

Coronary artery ectasia: Clinical and angiographical evaluation

Hale Yılmaz1, Nurten Sayar1, Mehmet Yılmaz2, Burak Tangürek1, Nazmiye Çakmak1, Ufuk Gürkan1, Mehmet Gül1, Dilek Şimşek1, Osman Bolca1
1Siyami Ersek Thoracic And Cardiovascular Surgery Training And Research Hospital, Department Of Cardiology, Istanbul, Turkey
2Siyami Ersek Thoracic And Cardiovascular Surgery Training And Research Hospital, Department Of Cardiovascular Surgery, Istanbul, Turkey


OBJECTIVES
We investigated the prevalence, distribution, risk factors, and prognosis of coronary artery ectasia (CAE) in patients undergoing coronary angiography for suspected coronary artery disease (CAD).

STUDY DESIGN
Of 4,119 patients undergoing elective coronary angiography between 2003 and 2005, 173 patients (139 males, 34 females; mean age 61±11 years) had CAE, with a prevalence of 4.2%. Distribution of CAE was made according to the classification of Markis et al. The results were compared with those of 145 control patients (115 males, 30 males; mean age 61±10 years) who had CAD but not CAE. Following coronary angiography, treatment was designed as aortocoronary bypass (n=3), percutaneous coronary intervention (n=36), and medical therapy (n=98). The mean follow-up was 34.2±2.5 months.

RESULTS
Among CAE patients, there was a marked male preponderance with 80.3%. Coronary ectasia was isolated in 46 patients (26.6%) and was associated with significant coronary artery stenoses in 127 patients (73.4%). The only significant difference with the control group with respect to baseline features was the higher frequency of hypertension in the CAE group (p=0.002). Coronary ectasia involved a single vessel in 67.1%, two vessels in 24.9%, and three vessels in 8.1%, with the right coronary artery being the most common localization (50.9%). The diameters of ectatic coronary arteries ranged from 3.2 mm to 9.7 mm (mean 5.6 mm). According to the classification of Markis et al., the majority of patients (64.2%) had type IV ectasia. In multiple regression analysis, hypertension was independently associated with CAE (OR: 0.378; 95% CI: 0.211-0.678; p=0.001). Mortality occurred in nine patients (5.2%). The annual mortality rates were 1.5%, 2.1%, and 2.9% with medical therapy, percutaneous coronary intervention, and aortocoronary bypass, respectively.

CONCLUSION
Our findings suggest that further prospective studies focus on the dependent relationship between hypertension and CAE, and on marked coexistence of CAD and CAE.

Keywords: Coronary aneurysm, coronary angiography, coronary artery disease; dilatation, pathologic

How to cite this article
Hale Yılmaz, Nurten Sayar, Mehmet Yılmaz, Burak Tangürek, Nazmiye Çakmak, Ufuk Gürkan, Mehmet Gül, Dilek Şimşek, Osman Bolca. Coronary artery ectasia: Clinical and angiographical evaluation. Turk Kardiyol Dern Ars. 2008; 36(8): 530-535

Corresponding Author: Hale Yılmaz, Türkiye
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