Adult isolated coronary artery ectasia: clinical features and long-term outcomes
Yihan Weng1,2, Jiquan Xiao2,3, Xiang He2,4
1Shantou University Medical College, Shantou, China.
Insights
Adult isolated coronary artery ectasia (ICAE) patients face a higher risk of major adverse cardiovascular events (MACE). This rare condition involves coronary artery dilation without significant stenosis, impacting long-term outcomes.
Area of Science:
- Cardiology
- Vascular Medicine
- Clinical Research
Background:
- Isolated Coronary Artery Ectasia (ICAE) is a rare condition characterized by coronary artery dilation without significant stenosis.
- Long-term prognosis and optimal management strategies for adult ICAE remain unclear.
- This study compares clinical and long-term outcomes of adult ICAE patients against controls with normal coronary arteries.
Purpose of the Study:
- To investigate the clinical characteristics of adult ICAE.
- To evaluate the long-term prognosis of adult ICAE.
- To compare outcomes between adult ICAE patients and matched controls.
Main Methods:
- Retrospective analysis of coronary angiography databases (2012-2022).
- ICAE defined as ≥1.5 times dilation with <20% stenosis, excluding secondary causes.
- 1:1 matching of 171 ICAE patients with 171 controls by age and sex.
Main Results:
- ICAE patients showed higher rates of hypertension, elevated cardiac biomarkers, and ECG abnormalities.
- Angiography revealed LAD predilection (70.8%), multivessel involvement, and slow flow (26.9%).
- After 6.2 years, ICAE patients had significantly higher MACE risk (HR 2.17) but similar all-cause mortality.
Conclusions:
- Adult ICAE presents unique clinical and angiographic features.
- The condition may be associated with a chronic ischemia-like phenotype.
- Adult ICAE is linked to an increased risk of major adverse cardiovascular events (MACE).
Background:
Adult isolated coronary artery ectasia (ICAE) is a rare disease characterized by dilation of coronary arteries in the absence of significant stenosis. Its long-term prognosis and optimal management remain unclear. This study aimed to investigate the clinical and long-term outcomes of adult ICAE compared to controls with normal coronary arteries.
Methods:
This retrospective analysis utilized prospectively maintained coronary angiography databases at Guangdong Provincial People's Hospital (2012-2022). ICAE was defined as ≥1.5 times dilation with <20% stenosis. Adult patients meeting these criteria, after excluding cases with significant stenosis or secondary causes, were matched 1:1 by age and sex to controls with normal coronary arteries. Clinical, laboratory, ECG, echocardiographic, and angiographic data were collected. The primary outcome was all-cause mortality, and the secondary outcome was major adverse cardiovascular events (MACE).
Results:
The study included 171 adult ICAE patients and 171 matched controls. Compared to controls, ICAE patients exhibited a higher prevalence of hypertension, elevated cardiac biomarkers, and more frequent ECG abnormalities. Angiography showed a predilection for the LAD (70.8%) and frequent multivessel involvement; slow flow was noted in 26.9%. After a median 6.2-year follow-up, ICAE patients had a significantly increased risk of MACE (HR 2.17, 95% CI 1.23-3.82, p = 0.006), while all-cause mortality was similar (HR 1.07, 95% CI 0.43-2.63, p = 0.886).
Conclusions:
Adult ICAE exhibits distinct clinical and angiographic features, consistent with a chronic ischemia-like phenotype and possible association with elevated MACE risk.
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