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Coronary artery involvements in Takayasu arteritis: systematic review of reports
1Department of Cardiothoracic Surgery, The First Hospital of Putian, Teaching Hospital, Fujian Medical University, Putian, Fujian, People's Republic of China.
Insights
Takayasu arteritis (TA) commonly affects the right coronary artery, often causing stenosis. Surgical treatment for coronary artery lesions in TA patients leads to better recovery rates and fewer reinterventions compared to interventional therapy.
Area of Science:
- Cardiovascular Medicine
- Rheumatology
- Vascular Biology
Background:
- Coronary artery involvement in Takayasu arteritis (TA) is not well-documented.
- Understanding these involvements is crucial for patient management.
Purpose of the Study:
- To comprehensively describe coronary artery lesions in Takayasu arteritis patients.
- To compare the efficacy of surgical versus interventional treatments for these lesions.
Main Methods:
- Systematic literature review of studies published over the past two decades.
- Inclusion of 59 reports detailing 141 patients with Takayasu arteritis and coronary artery involvement.
Main Results:
- The right coronary artery was most frequently affected.
- Stenosis was the predominant lesion type, with the coronary ostium being the most common site.
- 12.1% of patients were diagnosed with acute myocardial infarction.
- Surgical treatment demonstrated higher recovery rates and lower reintervention rates than interventional therapy.
- Inflammation-driven in-stent restenosis necessitated reinterventions after interventional procedures.
Conclusions:
- Surgical intervention is the preferred treatment for coronary artery lesions in Takayasu arteritis patients.
- TA-related coronary artery disease requires careful management due to potential complications like restenosis.
Abstract:
Coronary artery involvements in patients with Takayasu arteritis (TA) have not been sufficiently described. By comprehensive retrieval of the pertinent literature published in the past two decades, 59 reports including 141 patients were recruited into this study. In TA patients with coronary artery involvements, the right coronary artery was the most commonly affected. Stenosis was the most common coronary artery lesion, and the coronary ostium was the most commonly affected coronary segment. Acute myocardial infarction was diagnosed in 17 (12.1%) patients of this cohort. Patients receiving surgical treatment showed a higher recovery rate than interventionally treated patients. Interventional therapy was associated with a higher reintervention rate than surgical treatment. The inflammation condition in TA patients can lead to in-stent restenosis and warrant reinterventions. Surgical treatment is a preferable treatment of choice over interventional therapy for the coronary artery lesions of TA patients.
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