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[Asymptomatic ischemia in coronary arterial ectasia. Effects of anticoagulation]
A Almazán1, O Nandayapa, A Rangel
1Hospital de Especialidades, Centro Médico La Raza, IMSS, México, D.F.
Insights
Oral warfarin significantly improved outcomes for patients with coronary arterial ectasia. The treatment reduced unstable angina and silent ischemia, enhancing patient quality of life.
Area of Science:
- Cardiology
- Vascular Medicine
Context:
- Coronary arterial ectasia (CAE) is a rare condition characterized by the dilation of coronary arteries.
- Patients with CAE often experience symptoms like angina pectoris and myocardial infarction.
- Intracoronary thrombus formation is a potential complication in CAE.
Purpose:
- To evaluate the efficacy of anticoagulant therapy in managing symptoms and complications of isolated coronary arterial ectasia.
- To assess the impact of oral warfarin on unstable angina, myocardial infarction, and silent ischemia in CAE patients.
Summary:
- A study involving 23 patients with isolated coronary arterial ectasia (22 men, 1 woman; age 31-71 years) investigated the effects of oral warfarin.
- Before treatment, 16 patients had unstable angina, 9 had positive exercise EKGs, and 16 had silent ischemia (35.21 min/day).
- After oral warfarin administration, only 5 patients reported unstable angina, 7 had positive exercise EKGs, and silent ischemia duration decreased significantly (P < 0.001) to 12.47 min/day.
Impact:
- Anticoagulant therapy with oral warfarin demonstrates a significant positive impact on reducing ischemic events in patients with coronary arterial ectasia.
- The findings suggest that anticoagulation can be an effective strategy for managing symptoms and improving the prognosis of patients with this condition.
- Further research may explore long-term outcomes and optimal anticoagulation strategies for coronary arterial ectasia.
Abstract:
We studied 23 patients (22 men and 1 woman), their ages ranged from 31 to 71 years (55.9 +/- 9.7 years), with isolated coronary arterial ectasia. Seventeen patients presented angina pectoris, 19 had myocardial infarction. An angiographic image of intracoronary thrombus was observed in 5 patients. Before the administration of anticoagulants (oral warfarin) 16 patients showed unstable angina, the exercise EKG was positive in 9 patients, and 16 patients presented silent ischemia (showed by EKG-Holter), whose duration was 35.21 +/- 29.27 min per day. After anticoagulants, only 5 patients showed unstable angina pectoris. Exercise EKG was positive in 7 patients and only 7 patients showed silent ischemia, whose duration decreased significantly (P < 0.001) to 12.47 +/- 22.5 min per day.