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Coronary artery ectasia: angiographic, clinical profile and follow-up

S Harikrishnan1, K R Sunder, J Tharakan

  • 1Department of Cardiology, Sree Chitra Tirunal Institutefor Medical Sciences and Technology, Thiruvananthapuram (Kerala).

Indian Heart Journal
|March 21, 2001
PubMed

Insights

Coronary ectasia, a dilation of coronary arteries, affects 4.5% of patients. It is often linked with coronary artery disease but can occur independently, with similar long-term outcomes.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Vascular Biology

Background:

  • Coronary ectasia is a rare condition characterized by dilation of the coronary arteries.
  • Its association with atherosclerotic coronary artery disease and its clinical implications require further investigation.

Purpose of the Study:

  • To determine the incidence of coronary ectasia in patients undergoing coronary angiography.
  • To compare the clinical characteristics and outcomes of patients with coronary ectasia associated with coronary artery disease versus those without.
  • To assess the relationship between coronary ectasia and other vascular diseases.

Main Methods:

  • Retrospective review of 3200 coronary angiograms.
  • Classification of ectasia using a modified Markis et al. criteria.
  • Comparison of patients with ectasia (with and without coronary artery disease) to a control group with coronary artery disease alone.

Main Results:

  • An incidence of 4.5% for coronary ectasia was observed (144/3200).
  • The majority of ectasia cases (122/144) were associated with significant coronary artery disease.
  • Patients with ectasia alone showed better left ventricular function and negative stress tests compared to those with ectasia and coronary artery disease.
  • No increased incidence of ectasia was found in patients with thoracoabdominal aortic aneurysm or peripheral occlusive vascular disease.
  • Right coronary artery was the most commonly affected vessel.
  • Long-term follow-up revealed similar event rates across all groups.

Conclusions:

  • Coronary ectasia occurs in 4.5% of patients, frequently coexisting with coronary artery disease.
  • Ectasia alone is associated with preserved left ventricular function and negative stress tests.
  • Coronary ectasia does not appear to be associated with thoracoabdominal aortic aneurysm or peripheral occlusive vascular disease.
  • Long-term prognosis is similar for patients with and without ectasia, regardless of coronary artery disease status.

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