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The natural history of aneurysmal coronary artery disease

V P Demopoulos1, C D Olympios, C N Fakiolas

  • 1Department of Cardiology, Tzanio State Hospital, Pireus, Greece.

Heart (British Cardiac Society)
|August 1, 1997
PubMed

Insights

Coronary artery ectasia does not increase risk when combined with obstructive coronary artery disease. Patients with isolated ectasia have a good prognosis, with few cardiac events and good exercise capacity.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Ischemic Heart Disease

Background:

  • Coronary artery ectasia (CAE) is a dilation of coronary arteries.
  • Its contribution to ischemic heart disease (IHD) morbidity and mortality is not fully understood.
  • CAE can occur isolated or with obstructive coronary artery disease (CAD).

Purpose of the Study:

  • To evaluate the impact of CAE, alone or with obstructive CAD, on IHD outcomes.
  • To compare morbidity and mortality in patients with CAE versus those with obstructive CAD.

Main Methods:

  • Retrospective analysis of patients undergoing coronary arteriography.
  • Three groups were studied: CAE with obstructive CAD (Group A), isolated CAE (Group B), and obstructive CAD without CAE (Group C).
  • Patients were followed for approximately two years.

Main Results:

  • Group A patients showed similar outcomes to Group C regarding myocardial infarction, exercise performance, and cardiac death.
  • Patients with isolated CAE (Group B) had a lower incidence of previous myocardial infarction and better exercise tolerance.
  • Group B experienced no myocardial infarctions or cardiac deaths, with a low incidence of unstable angina.

Conclusions:

  • Coronary artery ectasia does not add risk when coexisting with obstructive coronary artery disease.
  • Isolated coronary artery ectasia is associated with a favorable prognosis.
  • The use of oral anticoagulants in patients with pure ectasia warrants careful consideration.
Abstract

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