Relationship between Endothelial Activation and Stress Index and Coronary Artery Ectasia

Coronary artery ectasia (CAE) is characterized by abnormal dilatation of the coronary arteries and is associated with endothelial dysfunction and systemic inflammation. The Endothelial Activation and Stress Index (EASIX) has emerged as a novel biomarker reflecting endothelial activation and inflammatory stress.

This study aimed to evaluate the association between EASIX score and the presence of CAE.

A total of 300 patients who underwent coronary angiography between July 2018 and December 2025 were retrospectively analyzed. The study was designed as a case-control study. Patients were divided into two groups according to the presence of CAE (150 CAE, 150 controls). The EASIX score was calculated using the following formula: EASIX = LDH × Creatinine / Platelet . Receiver operating characteristic (ROC) analysis was performed to determine the predictive value of EASIX for CAE. Youden index statistical analysis was performed to evaluate the diagnostic power of ROC analysis and to calculate the optimal cut-off value. A p-value < 0.05 was considered statistically significant.

Patients with CAE had significantly higher EASIX score compared with controls (1.46 ± 0.33 vs. 0.98 ± 0.74). In the ROC analysis, EASIX score had 72% sensitivity and 58% specificity when the cut-off value for EASIX≥ 0.74 (AUC=0.688, 95% CI:0.618-0.759, p<0.001). In Multivariable logistic regression analysis, the EASIX score was identified as an independent predictor of CAE (OR =2.12, 95% CI: 1.35-3.34, p=0.001).

The EASIX score was independently associated with the presence of CAE and demonstrated moderate discriminative ability.