Prevalence and Long-term Outcomes of Patients with Coronary Artery Ectasia Presenting with Acute Myocardial Infarction

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 478...

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Bibliographic Details
Published in:The American journal of cardiology 2021-10, Vol.156, p.9-15
Main Authors: Wang, Xu, Montero-Cabezas, Jose M, Mandurino-Mirizzi, Alessandro, Hirasawa, Kensuke, Ajmone Marsan, Nina, Knuuti, Juhani, Bax, Jeroen J, Delgado, Victoria
Format: Article
Language:English
Subjects:
Angiography
Arteries
Blood clots
Cardiovascular disease
Cerebral infarction
Coronary artery
Coronary vessels
Diabetes
Heart attacks
Heart surgery
Implants
Information systems
Males
Medical imaging
Myocardial infarction
Pathogenesis
Phenotypes
Regression analysis
Risk analysis
Risk factors
Segments
Stents
Stroke
Surgical implants
Survival analysis
Thrombosis
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Summary: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
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2021.06.037