Coronary artery ectasia: a ten-year experience in a tertiary hospital in Singapore
1Cardiac Department, The Heart Institute, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074.
Insights
The incidence of coronary artery ectasia (CAE) in Singapore is 1.2%, primarily affecting males in their fifth decade. Most patients had co-existing obstructive coronary artery disease, with the right coronary artery most frequently involved.
Area of Science:
- Cardiology
- Vascular Medicine
- Diagnostic Imaging
Background:
- Coronary artery ectasia (CAE) is a rare angiographic finding characterized by abnormal coronary dilatation.
- The incidence of CAE has not been previously described in Singapore.
Purpose of the Study:
- To determine the incidence of CAE at a Singaporean teaching hospital.
- To characterize the patient demographics and angiographic features of CAE.
Main Methods:
- Retrospective review of coronary angiography records from 1992-2001.
- Identification of CAE cases through a hospital computer database search.
Main Results:
- An incidence of 1.2% for CAE was observed in 104 out of 8641 patients.
- The majority of affected patients were male (74%), with a median age of 54, and common comorbidities included hypertension (58%) and dyslipidemia (63%).
- The right coronary artery (RCA) was most commonly affected (65%), with 82% of cases showing co-existent obstructive coronary artery disease.
Conclusions:
- The incidence of coronary artery ectasia in this Singaporean cohort is 1.2%.
- CAE predominantly affects middle-aged males and is frequently associated with obstructive coronary artery disease.
- The right coronary artery is the most commonly involved vessel, often presenting as single-vessel ectasia.
Introduction:
Coronary artery ectasia (CAE) is a well-recognised, albeit rare, angiographic finding of abnormal coronary dilatation. To our best knowledge, its incidence has never been described in Singapore. We aimed to determine the incidence of CAE at our teaching hospital and to describe patient and angiographic characteristics.
Materials And Methods:
Cases were identified through a search of our hospital's computer database and all records were reviewed.
Results:
Over the 10-year study period (1992-2001), 8641 patients underwent coronary angiography. CAE was diagnosed in 104 patients, giving an incidence of 1.2%. The majority (74%) were male. The median age was 54 years (range, 25 to 79 years). Sixty-six per cent of patients were Chinese, 19% Malays, 12% Indians and 3% other races. Concomitant diabetes mellitus was present in 31%, hypertension in 58% and dyslipidaemia in 63% of patients. Co-existent obstructive coronary artery disease was present in 82% of cases. The frequency of arterial involvement was: right coronary artery (RCA), 65%; left anterior descending artery (LAD), 48%; circumflex artery (CX), 43%; and left main artery (LM), 2%. CAE affected only 1 major vessel in 62% of cases and all 3 vessels in 20%. Eighteen patients were advised to undergo bypass surgery, while percutaneous coronary intervention was recommended in 26 patients.
Conclusions:
The incidence of ectasia was 1.2%. The majority of patients were males in their sixth decade with underlying dyslipidaemia or hypertension. CAE was associated with obstructive coronary artery disease in more than 80% of cases. The RCA was most commonly affected and most patients had single vessel involvement.
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