Prognostic role of coronary artery ectasia in patients with nonobstructive coronary artery disease

Area of Science:

• Cardiology
• Vascular Medicine
• Diagnostic Imaging

Background:

• Coronary artery ectasia (CAE) is associated with adverse events in patients with ischemia/angina and nonobstructive coronary arteries (INOCA/ANOCA).
• The prognostic implications of CAE in patients presenting with myocardial infarction and nonobstructive coronary arteries (MINOCA) remain under-investigated.

Purpose of the Study:

• To compare clinical, angiographic, and prognostic features of patients with CAE presenting with MINOCA versus INOCA/ANOCA.
• To assess the association between MINOCA presentation and major adverse cardiovascular events (MACE) in patients with CAE.

Main Methods:

• Retrospective analysis of 97 patients with angiographic evidence of CAE.
• Patients were categorized into MINOCA and INOCA/ANOCA groups.
• Clinical data, quantitative angiographic information, and MACE incidence at follow-up were recorded.

Main Results:

• MINOCA presentation was linked to higher rates of inflammatory diseases, multivessel CAE, and Thrombolysis In Myocardial Infarction (TIMI) flow < 3.
• Patients with MINOCA experienced a significantly higher incidence of MACE (16.3% vs. 4.2%) and nonfatal myocardial infarction (10.2% vs. 0%) at median 38-month follow-up.
• MINOCA presentation and TIMI flow < 3 were independent predictors of MACE.

Conclusions:

• In patients with CAE and nonobstructive coronary artery disease, MINOCA presentation is associated with a worse prognosis.
• MINOCA presentation independently predicts an increased risk of MACE in this patient cohort.