Post-PCI outcomes in STEMI patients with coronary ectasia: meta-analysis

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Tanveer Mir1, Yasar Sattar2, Mohammed Uddin1

  • 1Department of Internal Medicine, Detroit Medical Center, Wayne State University, Detroit, USA.

Expert Review of Cardiovascular Therapy
|February 15, 2021
PubMed

Insights

Percutaneous coronary intervention in ST-elevated myocardial infarction patients with coronary ectasia shows higher rates of PCI failure and no-reflow. However, follow-up mortality remains comparable between patients with and without ectasia.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Biology

Background:

  • Coronary ectasia (CE) involves coronary artery dilation, 1.5 times the surrounding vessel diameter.
  • Outcomes of percutaneous intervention (PCI) in ST-elevated myocardial infarction (STEMI) patients with CE are debated.

Purpose of the Study:

  • To compare PCI outcomes in STEMI patients with CE versus those without ectasia (NE).
  • To analyze factors influencing PCI success and complications in CE patients.

Main Methods:

  • Systematic review and meta-analysis of six studies comparing PCI outcomes in CE versus NE STEMI patients.
  • Analysis of baseline characteristics (TIMI flow, RCA involvement) and primary outcomes (thrombus aspiration, no-reflow, mortality, TIMI-3 flow).
  • Calculation of odds ratios (OR) and 95% confidence intervals (CI).

Main Results:

  • CE patients showed higher right coronary artery (RCA) involvement (OR 1.39) and greater thrombus aspiration use (OR 2.18).
  • Higher incidence of no-reflow (OR 4.07) and lower rates of TIMI-3 flow post-PCI (OR 0.64) were observed in CE patients.
  • Pre-procedure TIMI 0-1 flow and follow-up mortality were comparable between CE and NE groups.

Conclusions:

  • STEMI patients with CE experience higher rates of PCI failure and no-reflow compared to NE patients.
  • Despite procedural complications, long-term mortality following PCI is similar for both groups.
  • Comorbidities did not confound the observed outcomes in meta-regression analysis.
Abstract

Keywords:
Coronary ectasiacoronary artery aneurysmpcistemi

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