Coronary Artery Ectasia: A 10-Year Experience at a Single Center in Saudi Arabia
Talal F Aljabbary1, Meshal S Alhamed1, Mohamed H Ismaeel1,2
1Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Insights
Coronary artery ectasia (CAE) affects 2.3% of patients in Saudi Arabia, predominantly males. Isolated CAE shows better outcomes than when combined with atherosclerotic cardiovascular disease (ASCVD).
Area of Science:
- Cardiology
- Vascular Medicine
- Diagnostic Imaging
Background:
- Coronary artery ectasia (CAE) is an uncommon angiographic finding.
- Its prevalence, clinical characteristics, and long-term outcomes, particularly in Saudi Arabia, require further elucidation.
Purpose of the Study:
- To determine the incidence of coronary artery ectasia (CAE).
- To investigate the clinical characteristics and outcomes of CAE patients in Saudi Arabia over a decade.
Main Methods:
- Retrospective analysis of coronary angiography procedures from January 2013 to June 2023.
- Inclusion of patients diagnosed with CAE.
Main Results:
- An incidence of 2.3% for CAE was observed in 10,397 patients.
- The majority of CAE patients were male (92.6%), with a mean age of 57.15 years.
- Diffuse ectasia was most common (92.5%), affecting the RCA in 65.2%. Mixed CAE and atherosclerotic cardiovascular disease (ASCVD) showed higher rates of diabetes and smoking.
- Patients with mixed CAE and ASCVD had significantly higher composite endpoint rates (29% vs. 14%) during follow-up.
Conclusions:
- CAE is an infrequent finding, often associated with obstructive coronary artery disease (CAD).
- Outcomes differ based on the presence of obstructive disease; isolated CAE is associated with fewer adverse events.
Objective:
To assess the incidence of coronary artery ectasia (CAE) and its associated clinical characteristics and outcomes over a long follow-up period in Saudi Arabia.
Methods:
We retrospectively analyzed all coronary angiography procedures performed between January 2013 and June 2023. Patients with CAE were included in the final analysis.
Results:
During the 10-year period, 10,397 patients underwent coronary angiography. The CAE was diagnosed in 242 patients, yielding an incidence of 2.3%. The majority were male (92.6%). The average age was 57.15 ± 11.76 years. The right coronary artery (RCA) was the most involved vessel (65.2% of all patients). The most common anatomical morphology of ectasia was diffuse (92.5%), followed by saccular (4.5%) and fusiform (3%). A total of 26.8% of the patients had isolated CAE, while 73.1% had mixed CAE and atherosclerotic cardiovascular disease (ASCVD). The rates of diabetes (27.7% vs. 55.4%, p < 0.0001) and smoking (32.3% vs. 49.2%, p < 0.011) were significantly greater in the mixed CAE and ASCVD group. During a median follow-up of 510 days, the prevalence of composite endpoint was significantly greater in the mixed CAE and ASCVD group than in the isolated CAE group (29% vs. 14%, p = 0.04).
Conclusion:
Coronary artery ectasia is an uncommon angiographic finding, most often occurring in association with obstructive CAD. Outcomes appear to differ according to the presence of coexisting obstructive disease, with fewer events observed among patients with isolated CAE.
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