Percutaneous Coronary Intervention in Patients with Coronary Artery Ectasia: A Retrospective Single-center Study

Shoaib Subhan1, Muhammad Shehram1, Malik F Iftikhar2

  • 1Department of Cardiovascular Medicine, Cardiovascular Analytics Group, Islamabad, Pakistan.

Insights

Planned percutaneous coronary intervention (PCI) in patients with coronary ectasia shows better outcomes than ad-hoc PCI. This approach reduces mortality and major adverse cardiovascular events, highlighting its superiority for managing coronary ectasia.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Medicine

Background:

  • Coronary ectasia presents unique challenges for percutaneous coronary intervention (PCI).
  • The optimal timing for PCI in patients with coronary ectasia remains a subject of investigation.
  • Understanding outcomes differences between ad-hoc and planned PCI is crucial for clinical decision-making.

Purpose of the Study:

  • To compare the procedural outcomes and long-term results of ad-hoc versus planned PCI in patients diagnosed with coronary ectasia.
  • To identify predictors of mortality in this patient cohort.
  • To evaluate the impact of PCI strategy on major adverse cardiovascular events (MACE) and other clinical endpoints.

Main Methods:

  • Retrospective analysis of 3,179 patients with coronary ectasia undergoing PCI.
  • Comparison of baseline characteristics, technical success, stent deployment success, and MACE between ad-hoc and planned PCI groups.
  • Logistic regression analysis to determine independent predictors of mortality.

Main Results:

  • The ad-hoc PCI group had a higher prevalence of comorbidities and lower technical/stent deployment success rates.
  • Planned PCI was associated with significantly lower rates of MACE, all-cause mortality, recurrent angina, and target lesion revascularization.
  • Older age, male gender, hypertension, diabetes, smoking, multi-vessel disease, and coronary ectasia were identified as predictors of mortality.

Conclusions:

  • Planned PCI offers superior procedural outcomes and reduced mortality and adverse events compared to ad-hoc PCI in patients with coronary ectasia.
  • Coronary ectasia itself is an independent predictor of mortality.
  • These findings support a preference for planned PCI strategies in managing coronary ectasia.
Abstract

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