The Prevalence, Prediction and Angiographic Characteristics of Coronary Ectasia in Slemani Cardiac Center
Keywords:
coronary ectasia, acute coronary syndrome, angiographic characteristics, coronary angiographyAbstract
Background: Coronary artery ectasia (CAE) is an uncommon condition where a coronary artery becomesabnormally dilated. The present study was conducted in order to figure out the prevalence, prediction, and
angiographic characteristics of coronary ectasia at the Sulaymaniyah Cardiac Center.
Materials and methods: The present cross-sectional study was conducted on 70 patients with coronary
ectasia in in Sulaymaniyah cardiac center, Kurdistan region, Iraq from January to July 2022. Required data
were gathered through the patients' medical files and coronary angiography reports. The collected data were
analyzed via Statistical Package for Social Sciences (SPSS, version 24.0).
Results: Most of the patients (74.3%) were males. Most of them (80%) aged over 46 years. Acute coronary
syndrome (ACS) and chronic coronary syndrome were found in 60% and 37.1% of the patients, respectively.
Moreover, hypertension was observed in most of the patients (80%). The results revealed diffusion of two
or more vessels (37.1%) and diffusion of only one vessel (31.4%) as the most frequent types of coronary
ectasia. Classification of coronary ectasia was found to be significantly correlated with hypertension (pvalue=0.004) but not with the patients' age, gender, chronic coronary syndrome, smoking, or diabetes
mellitus (p-value>0.05).
Conclusion: The prevalence of coronary ectasia was found to be 3.3% among the studied population. Acute
coronary syndrome was the most common presentation associated with CAE. Right artery was the most
involved artery. Hypertension and smoking were found to be the most common risk factors for coronary
ectasia
References
Bahremand, M., Zereshki, E., Matin, B. K., Rezaei, M., & Omrani, H. (2021). Hypertension and
coronary artery ectasia: a systematic review and meta-analysis study. Clinical Hypertension, 27(1), 14.
https://doi.org/10.1186/s40885-021-00170-6.
Baldi, C., Silverio, A., Esposito, L., Di Maio, M., Tarantino, F., De Angelis, E., … Galasso, G. (2022).
Clinical outcome of patients with ST‐elevation myocardial infarction and angiographic evidence of
coronary artery ectasia. Catheterization and Cardiovascular Interventions: Official Journal of the
Society for Cardiac Angiography & Interventions, 99(2), 340–347. doi:10.1002/ccd.29738.
Brunetti, N. D., Salvemini, G., Cuculo, A., Ruggiero, A., De Gennaro, L., Gaglione, A., & Di Biase, M.
(2014). Coronary artery ectasia is related to coronary slow flow and inflammatory activation.
Atherosclerosis, 233(2), 636–640. doi:10.1016/j.atherosclerosis.2014.01.018.
Damay, V., Pranata, R., & Wiharja, W. (2019). Recurrent acute coronary syndrome in a patient with
right coronary artery ectasia: a case report. Journal of Medical Case Reports, 13(1).
https://doi.org/10.1186/s13256-019-1979-x.
Devabhaktuni, S., Mercedes, A., Diep, J., & Ahsan, C. (2016). Coronary artery ectasia-A- A review of
current literature. Current Cardiology Reviews, 12(4), 318–323.
doi:10.2174/1573403x12666160504100159.
Doi, T., Kataoka, Y., Noguchi, T., Shibata, T., Nakashima, T., Kawakami, S., … Yasuda, S. (2017).
Coronary artery ectasia predicts future cardiac events in patients with acute myocardial infarction.
Arteriosclerosis, Thrombosis, and Vascular Biology, 37(12), 2350–2355.
doi:10.1161/atvbaha.117.309683.
ElGuindy, M. S., & ElGuindy, A. M. (2018). Aneurysmal coronary artery disease: An overview. Global
Cardiology Science & Practice, 2017(3). doi:10.21542/gcsp.2017.26.
Esposito, L., Di Maio, M., Silverio, A., Cancro, F. P., Bellino, M., Attisano, T., Tarantino, F. F., Esposito,
G., Vecchione, C., Galasso, G., & Baldi, C. (2021). Treatment and outcome of patients with coronary
artery ectasia: Current evidence and novel opportunities for an old dilemma. Frontiers in Cardiovascular
Medicine, 8, 805727. https://doi.org/10.3389/fcvm.2021.805727.
Flood, D., Edwards, E. W., Giovannini, D., Ridley, E., Rosende, A., Herman, W. H., Jaffe, M. G., &
DiPette, D. J. (2022). Integrating hypertension and diabetes management in primary health care settings:
HEARTS as a tool. Revista Panamericana de Salud Publica [Pan American Journal of Public Health],
, e150. https://doi.org/10.26633/RPSP.2022.150.
Giannoglou, G. D., Antoniadis, A. P., Chatzizisis, Y. S., Damvopoulou, E., Parcharidis, G. E., &
Louridas, G. E. (2006). Prevalence of ectasia in human coronary arteries in patients in northern Greece
referred for coronary angiography. The American Journal of Cardiology, 98(3), 314–318.
https://doi.org/10.1016/j.amjcard.2006.02.034.
Gunasekaran, P., Stanojevic, D., Drees, T., Fritzlen, J., Haghnegahdar, M., McCullough, M., … Gupta,
K. (2019). Prognostic significance, angiographic characteristics and impact of antithrombotic and
anticoagulant therapy on outcomes in high versus low grade coronary artery ectasia: A long‐term
follow‐up study. Catheterization and Cardiovascular Interventions: Official Journal of the Society for
Cardiac Angiography & Interventions, 93(7), 1219–1227. doi:10.1002/ccd.27929.
Huang, Q.-J., Zhang, Y., Li, X.-L., Li, S., Guo, Y.-L., Zhu, C.-G., Xu, R.-X., Jiang, L.-X., Chen, M.-H.,
& Li, J.-J. (2014). Clinical features of coronary artery ectasia in the elderly. Journal of Geriatric
Cardiology: JGC, 11(3), 185–191. https://doi.org/10.11909/j.issn.1671-5411.2014.03.012.
Kawsara, A., Núñez Gil, I. J., Alqahtani, F., Moreland, J., Rihal, C. S., & Alkhouli, M. (2018).
Management of coronary artery aneurysms. JACC. Cardiovascular Interventions, 11(13), 1211–1223.
https://doi.org/10.1016/j.jcin.2018.02.041.
Khanal, S., Choudhary, A. K., & Kumar, B. (2023). A case report of high-risk percutaneous coronary
intervention of left main coronary artery with cardiogenic shock. Cureus. doi:10.7759/cureus.41983.
Khedr, A., Neupane, B., Proskuriakova, E., Jada, K., Kakieu Djossi, S., & Mostafa, J. A. (2021).
Pharmacologic management of coronary artery ectasia. Cureus. doi:10.7759/cureus.17832.
Khedr, A., Neupane, B., Proskuriakova, E., Jada, K., Kakieu Djossi, S., & Mostafa, J. A. (2021).
Pharmacologic management of coronary artery ectasia. Cureus, 13(9), e17832.
https://doi.org/10.7759/cureus.17832.
Liu, R., Zhao, H., Gao, X., & Liang, S. (2021). Is coronary artery ectasia a progressive disease? A selfcontrolled retrospective cohort study. Frontiers in Cardiovascular Medicine, 8, 774597.
https://doi.org/10.3389/fcvm.2021.774597.
Luo, Y., Tang, J., Liu, X., Qiu, J., Ye, Z., Lai, Y., Yao, Y., Li, J., Wang, X., & Liu, X. (2017). Coronary
artery aneurysm differs from coronary artery ectasia: Angiographic characteristics and cardiovascular
risk factor analysis in patients referred for coronary angiography. Angiology, 68(9), 823–830.
https://doi.org/10.1177/0003319716665690.
Matta, A. G., Yaacoub, N., Nader, V., Moussallem, N., Carrie, D., & Roncalli, J. (2021). Coronary artery
aneurysm: A review. World Journal of Cardiology, 13(9), 446–455. doi:10.4330/wjc.v13.i9.446.
Núñez-Gil, I. J., Terol, B., Feltes, G., Nombela-Franco, L., Salinas, P., Escaned, J., Jiménez-Quevedo,
P., Gonzalo, N., Vivas, D., Bautista, D., Macaya, C., & Fernández-Ortiz, A. (2018). Coronary aneurysms
in the acute patient: Incidence, characterization and long-term management results. Cardiovascular
Revascularization Medicine: Including Molecular Interventions, 19(5 Pt B), 589–596.
https://doi.org/10.1016/j.carrev.2017.12.003.
Patel, P., Shrivastava, R., Patel, R., & Warghane, P. (2023). Coronary artery ectasia. Indian Journal of
Clinical Cardiology, 4(1), 30–38. doi:10.1177/26324636231157469.
Pinar, B. E., López, P. R., Lozano, M.-L. I., Cortés, S. R., Carrillo Sáez P, Rodríguez, C. R., Picó, A. F.,
& Valdés, C. M. (2003). [Coronary ectasia: prevalence, and clinical and angiographic characteristics].
Revista Espanola de Cardiologia, 56(5). https://doi.org/10.1016/s0300-8932(03)76902-4.
Qin, Y., Tang, C., Ma, C., & Yan, G. (2019). Risk factors for coronary artery ectasia and the relationship
between hyperlipidemia and coronary artery ectasia. Coronary Artery Disease, 30(3), 211–215.
doi:10.1097/MCA.0000000000000709.
Richards, G. H. C., Hong, K. L., Henein, M. Y., Hanratty, C., & Boles, U. (2022). Coronary artery
ectasia: Review of the non-atherosclerotic molecular and pathophysiologic concepts. International
Journal of Molecular Sciences, 23(9), 5195. doi:10.3390/ijms23095195.
Willner NA, Ehrenberg S, Musallam A, et al. (2020). Coronary artery ectasia: prevalence, angiographic
characteristics and clinical outcomeOpen Heart 2020;7:e001096. doi: 10.1136/openhrt-2019-001096.
Zhu, X., Zhou, Q., Tong, S., & Zhou, Y. (2021). Challenges and strategies in the management of
coronary artery aneurysms. Hellenike Kardiologike Epitheorese [Hellenic Journal of Cardiology],
(2), 112–120. doi:10.1016/j.hjc.2020.09.004.
Zografos, T. A., Korovesis, S., Giazitzoglou, E., Kokladi, M., Venetsanakos, I., Paxinos, G., Fragakis,
N., & Katritsis, D. G. (2013). Clinical and angiographic characteristics of patients with coronary artery
ectasia. International Journal of Cardiology, 167(4), 1536–1541.
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