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Five-years' prognostic analysis for coronary artery ectasia patients with coronary atherosclerosis: A retrospective

Ruifeng Liu1, Xiangyu Gao1, Siwen Liang1

  • 1Department of Cardiology, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing, China.

Frontiers in Cardiovascular Medicine
|October 28, 2022
PubMed

Insights

Coronary artery ectasia (CAE) patients with acute myocardial infarction (AMI) have a worse prognosis. CAE patients with coronary heart disease (CHD) also face poorer outcomes. Medications like antiplatelets and ACEI/ARBs aid CAE + AMI patients, while managing stenosis is key for CAE patients.

Area of Science:

  • Cardiology
  • Cardiovascular Research
  • Clinical Prognosis Studies

Background:

  • Coronary artery ectasia (CAE) frequently coexists with coronary atherosclerosis.
  • Limited prognostic data exists for CAE patients with coronary heart disease (CHD) and acute myocardial infarction (AMI).

Purpose of the Study:

  • To determine the overall prognosis for patients with coronary artery ectasia (CAE).
  • To compare outcomes for CAE patients with comorbid acute myocardial infarction (AMI) and coronary heart disease (CHD) against relevant control groups.

Main Methods:

  • Retrospective cohort study design.
  • Inclusion of 51 CAE + AMI patients and 108 CAE + CHD patients.
  • Propensity score matching used to create control groups: 153 AMI patients, 324 CHD patients, and 329 normal coronary artery participants (CON).
  • Follow-up to observe major cardiovascular events (MACE).

Main Results:

  • CAE + AMI patients exhibited a significantly worse prognosis than AMI patients (5-year non-MACE rate: 62.70% vs. 79.70%, P=0.010).
  • CAE patients showed a worse prognosis compared to CHD and CON groups (5-year non-MACE rate: 74.10% vs. 85.80% and 96.70%, P=0.000).
  • Key MACEs included AMI reoccurrence in CAE + AMI and re-hospitalization for angina in CAE. Antiplatelet agents and ACEI/ARBs were protective in CAE + AMI, while coronary stenosis degree (Gensini score) promoted MACE in CAE.

Conclusions:

  • Prognosis is worse for CAE patients with AMI and for CAE patients with CHD compared to their respective controls.
  • CAE + AMI patients are prone to AMI reoccurrence; CAE patients are prone to repeated angina pectoris.
  • Treatment strategies should include antiplatelets and ACEI/ARBs for CAE + AMI, and focus on preventing atherosclerotic lesion progression for CAE patients.
Abstract

Keywords:
acute myocardial infarction (AMI)coronary artery ectasia (CAE)coronary heart disease (CHD)major cardiovascular events (MACE)prognosis

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