The natural history of aneurysmal coronary artery disease.
V. P. Demopoulos,Christopher D. Olympios,C. N. Fakiolas,E. G. Pissimissis,N. M. Economides,Evdokia N. Adamopoulou,Stefanos G. Foussas,Dennis V. Cokkinos +7 more
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TLDR
Although there is a measurable incidence of previous myocardial infarction, patients with pure ectasia have a good prognosis and the wisdom of giving oral anticoagulants to such patients is questioned.Abstract:
OBJECTIVE: To assess the contribution of coronary artery ectasia, either isolated or in association with obstructive coronary artery disease, to morbidity and mortality from ischaemic heart disease. DESIGN: A retrospective study of patients undergoing coronary arteriography at a tertiary cardiac centre. PATIENTS AND METHODS: The epidemiological, clinical, arteriographic, and follow up characteristics of three groups of patients were examined: group A, 172 patients with coronary artery ectasia and coexisting significant coronary artery disease; group B, 31 patients with coronary artery ectasia only; group C, 165 patients with significant coronary artery disease but without ectasia, matched for sex and age with group A. RESULTS: Group A patients had a similar incidence of a previous myocardial infarction to group C patients (61.6% v 64.2%), exercise performance, severity of obstructive lesions (CASS score 2.19 v 2.14), and similar distribution of diseased vessels. At follow up of approximately two years they experienced a similar incidence of unstable angina (7.5% v 4.4%) and myocardial infarction plus cardiac death (4.9% v 6.1%). They underwent bypass surgery with similar frequency (39% v 42%) but there was a lower frequency of percutaneous transluminal coronary angioplasty (5.8% v 17%, P < 0.01). Patients with pure coronary ectasia (group B) had a lower incidence of a previous myocardial infarction (38.7%, 12/31, P < 0.05) than the two other groups. The infarct in all cases was related to an ectatic artery. Their exercise performance and ejection fraction (9 (SD 3) minutes and 56.5(9)%) were higher (P < 0.01) than group A (5 (2) minutes, 48.3(10)%) and group C (5.3 (2) minutes, 49.3(10)%). Group B had no myocardial infarctions, cardiac death, surgery, or intervention at follow up; 4.4% (5/115) developed unstable angina. The incidence of angina at study entry was similar in all three groups (38.7-49.7%). CONCLUSIONS: Coronary artery ectasia does not confer added risk in patients with coexisting obstructive coronary artery disease. Although there is a measurable incidence of previous myocardial infarction, patients with pure ectasia have a good prognosis. The wisdom of giving oral anticoagulants to such patients is questioned.read more
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Exercise-induced myocardial ischemia in isolated coronary artery ectasias and aneurysms (“dilated coronaropathy”)
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Polymorphisms in the promoter regions of MMP-2, MMP-3, MMP-9 and MMP-12 genes as determinants of aneurysmal coronary artery disease.
Nicolas Lamblin,Christophe Bauters,Xavier Hermant,Jean-Marc Lablanche,Nicole Helbecque,P. Amouyel +5 more
TL;DR: The results suggest that an increased proteolysis in the arterial wall may act as a susceptibility factor for the development of CA in patients with coronary atherosclerosis.
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TL;DR: This paper aims to provide a succinct review of aneurysmal coronary disease, with a special emphasis on the challenges associated with its interventional treatment.
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Coronary artery aneurysms: a review of the natural history, pathophysiology, and management.
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TL;DR: This review summarizes the current state of knowledge on coronary artery aneurysms and highlights important unresolved questions.
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Coronary Artery Aneurysms After Drug-Eluting Stent Implantation
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P S Swaye,Lloyd D. Fisher,P Litwin,P A Vignola,Melvin P. Judkins,H G Kemp,J G Mudd,Arthur J. Gosselin +7 more
TL;DR: It is suggested that aneurysmal coronary disease does not represent a distinct clinical entity but is, rather, a variant of coronary atherosclerosis.
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Clinical significance of coronary arterial ectasia
TL;DR: Patients with ectasia did not differ from patients with obstructive disease in sex, age, prevalence of angina or presence of metabolic abnormalities, and the short-term prognosis is the same as in medically treated patients with three vessel obstructive coronary artery disease.
Journal ArticleDOI
Coronary artery ectasia. Its prevalence and clinical significance in 4993 patients.
TL;DR: To assess the clinical significance of coronary artery ectasia 4993 consecutive coronary arteriograms were reviewed to identify patients with this condition and to allow the assessment of their progress.