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Sannino M, Nicolai M, Infusino F, Giulio L, Usai TL, Biscotti G, Azzarri A, De Angelis D’Ossat M, Calcagno S, Calcagno S. Coronary Artery Aneurysms: A Clinical Case Report and Literature Review Supporting Therapeutic Choices. J Clin Med 2024; 13:5348. [PMID: 39336835 PMCID: PMC11432381 DOI: 10.3390/jcm13185348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 08/31/2024] [Accepted: 09/06/2024] [Indexed: 09/30/2024] Open
Abstract
Coronary artery aneurysms (CAAs) are uncommon but significant cardiovascular abnormalities characterized by an abnormal increase in vascular diameter. CAAs are classified based on their shape as either saccular or fusiform, and their causes can range from atherosclerosis, Kawasaki disease, to congenital and iatrogenic factors. CAAs often present asymptomatically, but when symptoms occur, they can include angina, myocardial infarction, or even sudden cardiac death due to intravascular thrombosis involving the CAA. Diagnosis is typically confirmed through coronary angiography, though CT and other imaging techniques can provide additional details. The management of CAAs is variable depending on their size, location, and the presence of symptoms or complications. Treatment options include medical therapy, percutaneous coronary intervention (PCI), or surgical approaches. In this paper, we describe the case report of a 79-year-old male who presented with palpitations and was diagnosed with a right coronary artery aneurysm, and a review of the literature is delineated, underscoring the importance of individualized treatment strategies for CAAs.
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Affiliation(s)
- Michele Sannino
- Cardiology Unit, Department of Emergency and Admission, San Paolo Hospital, Largo Donatori di Sangue 1, 00053 Civitavecchia, Italy; (M.S.); (L.G.); (T.L.U.); (G.B.); (A.A.); (S.C.)
| | - Matteo Nicolai
- Radiodiagnostic Unit, San Paolo Hospital, Largo Donatori di Sangue 1, 00053 Civitavecchia, Italy; (M.N.); (M.D.A.D.)
| | - Fabio Infusino
- Division of Cardiology, S. Giovanni Evangelista Hospital, 00019 Tivoli, Italy;
| | - Luciani Giulio
- Cardiology Unit, Department of Emergency and Admission, San Paolo Hospital, Largo Donatori di Sangue 1, 00053 Civitavecchia, Italy; (M.S.); (L.G.); (T.L.U.); (G.B.); (A.A.); (S.C.)
| | - Tommaso Leo Usai
- Cardiology Unit, Department of Emergency and Admission, San Paolo Hospital, Largo Donatori di Sangue 1, 00053 Civitavecchia, Italy; (M.S.); (L.G.); (T.L.U.); (G.B.); (A.A.); (S.C.)
| | - Giovanni Biscotti
- Cardiology Unit, Department of Emergency and Admission, San Paolo Hospital, Largo Donatori di Sangue 1, 00053 Civitavecchia, Italy; (M.S.); (L.G.); (T.L.U.); (G.B.); (A.A.); (S.C.)
| | - Alessandro Azzarri
- Cardiology Unit, Department of Emergency and Admission, San Paolo Hospital, Largo Donatori di Sangue 1, 00053 Civitavecchia, Italy; (M.S.); (L.G.); (T.L.U.); (G.B.); (A.A.); (S.C.)
| | - Marina De Angelis D’Ossat
- Radiodiagnostic Unit, San Paolo Hospital, Largo Donatori di Sangue 1, 00053 Civitavecchia, Italy; (M.N.); (M.D.A.D.)
| | - Sergio Calcagno
- Cardiology Unit, Department of Emergency and Admission, San Paolo Hospital, Largo Donatori di Sangue 1, 00053 Civitavecchia, Italy; (M.S.); (L.G.); (T.L.U.); (G.B.); (A.A.); (S.C.)
| | - Simone Calcagno
- Cardiology Unit, Department of Emergency and Admission, San Paolo Hospital, Largo Donatori di Sangue 1, 00053 Civitavecchia, Italy; (M.S.); (L.G.); (T.L.U.); (G.B.); (A.A.); (S.C.)
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Woźniak P, Iwańczyk S, Błaszyk M, Stępień K, Lesiak M, Mularek-Kubzdela T, Araszkiewicz A. Coronary Artery Aneurysm or Ectasia as a Form of Coronary Artery Remodeling: Etiology, Pathogenesis, Diagnostics, Complications, and Treatment. Biomedicines 2024; 12:1984. [PMID: 39335497 PMCID: PMC11428638 DOI: 10.3390/biomedicines12091984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Revised: 08/19/2024] [Accepted: 08/29/2024] [Indexed: 09/30/2024] Open
Abstract
Coronary artery aneurysm or ectasia (CAAE) is a term that includes both coronary artery ectasia (CAE) and coronary artery aneurysm (CAA), despite distinct phenotypes and definitions. This anomaly can be found in 0.15-5.3% of coronary angiography. CAE is a diffuse dilatation of the coronary artery at least 1.5 times wider than the diameter of the normal coronary artery in a patient with a length of over 20 mm or greater than one-third of the vessel. CAE can be further subdivided into diffuse and focal dilations by the number and the length of the dilated vessels. Histologically, it presents with extensive destruction of musculoelastic elements, marked degradation of collagen and elastic fibers, and disruption of the elastic lamina. Conversely, CAA is a focal lesion manifesting as focal dilatation, which can be fusiform (if the longitudinal diameter is greater than the transverse) or saccular (if the longitudinal diameter is smaller than the transverse). Giant CAA is defined as a 4-fold enlargement of the vessel diameter and is observed in only 0.02% of patients after coronary. An aneurysmal lesion can be either single or multiple. It can be either a congenital or acquired phenomenon. The pathophysiological mechanisms responsible for the formation of CAAE are not well understood. Atherosclerosis is the most common etiology of CAAE in adults, while Kawasaki disease is the most common in children. Other etiological factors include systemic connective tissue diseases, infectious diseases, vasculitis, congenital anomalies, genetic factors, and idiopathic CAA. Invasive assessment of CAAE is based on coronary angiography. Coronary computed tomography (CT) is a noninvasive method that enables accurate evaluation of aneurysm size and location. The most common complications are coronary spasm, local thrombosis, distal embolization, coronary artery rupture, and compression of adjacent structures by giant coronary aneurysms. The approach to each patient with CAAE should depend on the severity of symptoms, anatomical structure, size, and location of the aneurysm. Treatment methods should be carefully considered to avoid possible complications of CAAE. Simultaneously, we should not unnecessarily expose the patient to the risk of intervention or surgical treatment. Patients can be offered conservative or invasive treatment. However, there are still numerous controversies and ambiguities regarding the etiology, prognosis, and treatment of patients with coronary artery aneurysms. This study summarizes the current knowledge about this disease's etiology, pathogenesis, and management.
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Affiliation(s)
- Patrycja Woźniak
- 1st Department of Cardiology, Poznan University of Medical Sciences, Długa 1/2 Street, 61-848 Poznań, Poland
| | - Sylwia Iwańczyk
- 1st Department of Cardiology, Poznan University of Medical Sciences, Długa 1/2 Street, 61-848 Poznań, Poland
| | - Maciej Błaszyk
- Department of Radiology, Poznan University of Medical Sciences, 61-701 Poznań, Poland
| | - Konrad Stępień
- Department of Coronary Artery Disease and Heart Failure, Jagiellonian University Medical College, Prądnicka 80 Street, 31-202 Kraków, Poland
| | - Maciej Lesiak
- 1st Department of Cardiology, Poznan University of Medical Sciences, Długa 1/2 Street, 61-848 Poznań, Poland
| | - Tatiana Mularek-Kubzdela
- 1st Department of Cardiology, Poznan University of Medical Sciences, Długa 1/2 Street, 61-848 Poznań, Poland
| | - Aleksander Araszkiewicz
- 1st Department of Cardiology, Poznan University of Medical Sciences, Długa 1/2 Street, 61-848 Poznań, Poland
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Piedimonte G, Cerrato E, Rolfo C, Nunez Gil IJ, Azzalini L, Mangione R, Maiellaro F, Boi A, Riganelli D, Sardone A, Bruno F, Scudiero F, Vizzari G, Carciotto G, Calderone D, Borgi M, Cancro FP, Sanchez I, Leoncini M, Sagazio E, Colombo F, Rosso G, Chechi T, Zecchino S, Pavani M, Franzè A, Zanda G, Bosco M, Hernandez JMDLT, Micari A, Galasso G, Versaci F, Tamburino C, Patti G, La Manna A, Tomassini F, Varbella F. Percutaneous coronary interventions for aneurysmatic right coronary artery in acute coronary syndrome: RIGHTMARE registry outcomes. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2024:S1553-8389(24)00633-X. [PMID: 39181812 DOI: 10.1016/j.carrev.2024.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 07/31/2024] [Accepted: 08/14/2024] [Indexed: 08/27/2024]
Abstract
BACKGROUND The optimal strategy during percutaneous coronary intervention (PCI) of aneurysmatic right coronary artery (ARCA) remains uncertain and has never been tested in the acute setting. OBJECTIVES To compare the in-hospital and long-term outcomes of immediate and staged PCI strategies for ARCA as culprit lesions during acute coronary syndrome (ACS). METHODS Among 102.376 PCIs performed in 18 European centers, a total of 85 patients presenting with acute coronary syndrome undergoing ARCA PCI were finally included in the analysis. PCI strategy (stenting performed during the immediate vs staged procedure) and pharmacological approach adopted were collected. The primary outcome was procedural success (technical success without in-hospital MACE). RESULTS The primary outcome occurred in 48.2 % of cases, with no significant differences observed between the immediate and staged PCI groups (50.9 % vs 43.3 %, p = 0.504). Patients in the staged-PCI group had a significantly higher rate of intravenous anticoagulant use (83.3 % vs 48.1 %, p = 0.002), BARC type 3 and 5 bleedings (12.9 % vs 1.9 %, p = 0.037), and longer in-hospital stay (7.40 ± 5.11 vs 9.5 ± 5.25 days, p = 0.049). After multivariate analysis, no independent predictors for procedural success were found in either group. Target lesion failure occurred in 24.1 % of cases without differences between groups at a median follow-up of three years. CONCLUSIONS Among patients undergoing ARCA PCI in the setting of ACS, immediate or staged PCI were associated with similar in-hospital and long-term outcomes. However, staged PCI was associated with a higher risk of major bleeding events and longer length of stay compared to immediate PCI strategy.
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Affiliation(s)
- Giulio Piedimonte
- Division of Cardiology, Interventional Unit - Infermi Rivoli Hospital, Rivoli (Turin), Italy and San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy.
| | - Enrico Cerrato
- Division of Cardiology, Interventional Unit - Infermi Rivoli Hospital, Rivoli (Turin), Italy and San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - Cristina Rolfo
- Division of Cardiology, Interventional Unit - Infermi Rivoli Hospital, Rivoli (Turin), Italy and San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - Ivan J Nunez Gil
- Cardiovascular Institute, Hospital Clínico San Carlos, Madrid, Spain
| | - Lorenzo Azzalini
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Riccardo Mangione
- Division of Cardiology, Policlinico University G.Rodolico-San Marco, Catania, Italy
| | | | - Alberto Boi
- Division of Cardiology, Azienda Ospedaliera G. Brotzu, Cagliari, Italy
| | - Donovan Riganelli
- Division of Cardiology, Azienda Ospedaliera G. Brotzu, Cagliari, Italy
| | - Andrea Sardone
- Division of Cardiology, Sant'Elia Hospital, Caltanissetta, Italy
| | - Francesco Bruno
- Division of Cardiology, Cardiovascular and Thoracic Department, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Fernando Scudiero
- Cardiology Unit, Medical Sciences Department, ASST Bergamo Est, Seriate, Bergamo, Italy
| | - Giampiero Vizzari
- Department of Clinical and Experimental Medicine, Interventional Cardiology Unit, "G. Martino" University Hospital of Messina, Italy
| | - Gabriele Carciotto
- Department of Clinical and Experimental Medicine, Interventional Cardiology Unit, "G. Martino" University Hospital of Messina, Italy
| | - Dario Calderone
- Department of Invasive Cardiology, San Luca Hospital - Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Marco Borgi
- Division of Cardiology, Santa Maria Goretti Hospital, Latina, Italy
| | - Francesco Paolo Cancro
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Italy
| | - Ivan Sanchez
- Cardiovascular Institute, Hospital Clínico San Carlos, Madrid, Spain
| | | | | | | | - Gabriele Rosso
- Division of Cardiology, Santa Maria Annunziata Hospital, Florence, Italy
| | - Tania Chechi
- Division of Cardiology, Santa Maria Annunziata Hospital, Florence, Italy
| | - Simone Zecchino
- Division of Cardiology, Interventional Unit - Infermi Rivoli Hospital, Rivoli (Turin), Italy and San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - Marco Pavani
- Division of Cardiology, Interventional Unit - Infermi Rivoli Hospital, Rivoli (Turin), Italy and San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - Alfonso Franzè
- Division of Cardiology, Interventional Unit - Infermi Rivoli Hospital, Rivoli (Turin), Italy and San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - Greca Zanda
- Division of Cardiology, Interventional Unit - Infermi Rivoli Hospital, Rivoli (Turin), Italy and San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - Manuel Bosco
- Division of Cardiology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy
| | | | - Antonio Micari
- Department of Clinical and Experimental Medicine, Interventional Cardiology Unit, "G. Martino" University Hospital of Messina, Italy
| | - Gennaro Galasso
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Italy
| | | | - Corrado Tamburino
- Division of Cardiology, Policlinico University G.Rodolico-San Marco, Catania, Italy
| | - Giuseppe Patti
- Division of Cardiology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy
| | - Alessio La Manna
- Division of Cardiology, Policlinico University G.Rodolico-San Marco, Catania, Italy
| | - Francesco Tomassini
- Division of Cardiology, Interventional Unit - Infermi Rivoli Hospital, Rivoli (Turin), Italy and San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - Ferdinando Varbella
- Division of Cardiology, Interventional Unit - Infermi Rivoli Hospital, Rivoli (Turin), Italy and San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
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Zhang S, Wang W, Gong Y, Wu S. Postoperative giant left coronary artery aneurysm: A case report. Asian J Surg 2024:S1015-9584(24)01200-4. [PMID: 38876854 DOI: 10.1016/j.asjsur.2024.05.290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 05/31/2024] [Indexed: 06/16/2024] Open
Affiliation(s)
- Shibiao Zhang
- Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Wei Wang
- Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yibo Gong
- Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Sijie Wu
- Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, China.
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Tsujimoto K, Osawa K, Yoshida H, Kuinose M. Giant coronary artery aneurysm in the atrial septum. BMJ Case Rep 2024; 17:e257748. [PMID: 38851223 DOI: 10.1136/bcr-2023-257748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2024] Open
Abstract
A man in his 60s with paroxysmal atrial fibrillation was scheduled for a catheter ablation but was admitted to our department after contrast-enhanced CT showed a large homogeneous right atrial mass (52×52 mm) as well as a dilated right coronary artery (RCA). Coronary artery angiography showed a large fistula from the RCA to the mass in the right atrium. A giant coronary artery aneurysm was suspected and a surgical resection was performed. The mass was attached to the atrial septal wall and was palpated in the right atrium with a feeding artery from the RCA. The final diagnosis was an extremely rare case of giant coronary artery aneurysm originating from the RCA. The surgery was successful, and the patient was discharged 30 days later.
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Affiliation(s)
- Kotone Tsujimoto
- Department of Surgery, Kawasaki Medical School Kawasaki Hospital, Okayama, Japan
| | - Kazuhiro Osawa
- Department of General Internal Medicine, Kawasaki Medical School Kawasaki Hospital, Okayama, Japan
| | - Hideo Yoshida
- Department of Surgery, Kawasaki Medical School Kawasaki Hospital, Okayama, Japan
| | - Masahiko Kuinose
- Department of Surgery, Kawasaki Medical School Kawasaki Hospital, Okayama, Japan
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Somsen YB, Porouchani S, de Winter RW, Zandbergen HR, Jansen EK, Nap A, Niessen HW, Knaapen P. Unmasking of a Giant Coronary Aneurysm by Chronic Total Coronary Occlusion Percutaneous Coronary Intervention Techniques. JACC Case Rep 2024; 29:102359. [PMID: 38725652 PMCID: PMC11079459 DOI: 10.1016/j.jaccas.2024.102359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/25/2024] [Accepted: 03/27/2024] [Indexed: 05/12/2024]
Abstract
A young female patient presenting with a non-ST-segment elevation myocardial infarction underwent invasive coronary angiography, revealing a total occlusion of the right coronary artery. During percutaneous coronary intervention with dual catheter access, a retrograde tip injection and peculiar retrograde wiring unmasked a giant coronary aneurysm, which noninvasive imaging confirmed.
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Affiliation(s)
- Yvemarie B.O. Somsen
- Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Sina Porouchani
- Department of Cardiology, Lille University Hospital, Lille, France
| | - Ruben W. de Winter
- Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Harmen R. Zandbergen
- Department of Cardiothoracic Surgery, Amsterdam UMC, Amsterdam Medical Center, Amsterdam, the Netherlands
| | - Evert K. Jansen
- Department of Cardiothoracic Surgery, Amsterdam UMC, Amsterdam Medical Center, Amsterdam, the Netherlands
| | - Alexander Nap
- Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Hans W.M. Niessen
- Department of Pathology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Paul Knaapen
- Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Candreva A, De Nisco G, Lodi Rizzini M, D’Ascenzo F, De Ferrari GM, Gallo D, Morbiducci U, Chiastra C. Current and Future Applications of Computational Fluid Dynamics in Coronary Artery Disease. Rev Cardiovasc Med 2022; 23:377. [PMID: 39076179 PMCID: PMC11269074 DOI: 10.31083/j.rcm2311377] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 09/02/2022] [Accepted: 09/26/2022] [Indexed: 07/31/2024] Open
Abstract
Hemodynamics interacts with the cellular components of human vessels, influencing function and healthy status. Locally acting hemodynamic forces have been associated-by a steadily increasing amount of scientific evidence-with nucleation and evolution of atherosclerotic plaques in several vascular regions, resulting in the formulation of the 'hemodynamic risk hypothesis' of the atherogenesis. At the level of coronary arteries, however, the complexity of both anatomy and physiology made the study of this vascular region particularly difficult for researchers. Developments in computational fluid dynamics (CFD) have recently allowed an accurate modelling of the intracoronary hemodynamics, thus offering physicians a unique tool for the investigation of this crucial human system by means of advanced mathematical simulations. The present review of CFD applications in coronary artery disease was set to concisely offer the medical reader the theoretical foundations of quantitative intravascular hemodynamics-reasoned schematically in the text in its basic (i.e., pressure and velocity) and derived quantities (e.g., fractional flow reserve, wall shear stress and helicity)-along with its current implications in clinical research. Moreover, attention was paid in classifying computational modelling derived from invasive and non-invasive imaging modalities with unbiased remarks on the advantages and limitations of each procedure. Finally, an extensive description-aided by explanatory figures and cross references to recent clinical findings-was presented on the role of near-wall hemodynamics, in terms of shear stress, and of intravascular flow complexity, in terms of helical flow.
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Affiliation(s)
- Alessandro Candreva
- PoliToMed Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, 10129 Torino, Italy
- Department of Cardiology, Zurich University Hospital, 8091 Zurich, Switzerland
| | - Giuseppe De Nisco
- PoliToMed Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, 10129 Torino, Italy
| | - Maurizio Lodi Rizzini
- PoliToMed Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, 10129 Torino, Italy
| | - Fabrizio D’Ascenzo
- Department of Medical Sciences, Division of Cardiology, AOU Città Della Salute e Della Scienza, University of Turin, 10124 Turin, Italy
| | - Gaetano Maria De Ferrari
- Department of Medical Sciences, Division of Cardiology, AOU Città Della Salute e Della Scienza, University of Turin, 10124 Turin, Italy
| | - Diego Gallo
- PoliToMed Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, 10129 Torino, Italy
| | - Umberto Morbiducci
- PoliToMed Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, 10129 Torino, Italy
| | - Claudio Chiastra
- PoliToMed Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, 10129 Torino, Italy
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Navarro-Zambrano G, Martínez-Hernández H, Mero-Vélez R, Castillo Castellón F. Abordaje quirúrgico para un aneurisma gigante de la arteria coronaria izquierda: caso clínico. CIRUGIA CARDIOVASCULAR 2022. [DOI: 10.1016/j.circv.2022.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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9
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Arslan F, Núñez-Gil IJ, Rodríguez-Olivares R, Cerrato E, Bollati M, Nombela-Franco L, Terol B, Alfonso-Rodríguez E, Camacho Freire SJ, Villablanca PA, Amat Santos IJ, De la Torre Hernández JM, Pascual I, Liebetrau C, Alkhouli M, Fernández-Ortiz A. Sex differences in treatment strategy for coronary artery aneurysms: Insights from the international Coronary Artery Aneurysm Registry. Neth Heart J 2021; 30:328-334. [PMID: 34910278 PMCID: PMC9123134 DOI: 10.1007/s12471-021-01649-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction Sex disparities exist in coronary artery disease (CAD) in terms of risk profile, clinical management and outcome. It is unclear if differences are also present in coronary aneurysms, a rare variant of CAD. Methods Patients were selected from the international Coronary Artery Aneurysm Registry (CAAR; ClinicalTrials.gov: NCT02563626), and differences between groups were analysed according to sex. The CAAR database is a prospective multicentre registry of 1565 patients with coronary aneurysms (336 females). Kaplan-Meier method was used for event-free survival analysis for death, major adverse cardiac events (MACE: composite endpoint of death, heart failure and acute coronary syndrome) and bleeding. Results Female patients were older, were more often hypertensive and less frequently smoker. They were treated conservatively more often compared to male patients and received significantly less frequently aspirin (92% vs 88%, p = 0.002) or dual antiplatelet therapy (DAPT) (67% vs 58%, p = 0.001) at discharge. Median DAPT duration was also shorter (3 vs 9 months, p = 0.001). Kaplan-Meier analysis revealed no sex differences in death, MACE or bleeding during a median follow-up duration of 37 months, although male patients did experience acute coronary syndrome (ACS) more often during follow-up (15% vs 10%, p = 0.015). Conclusions These CAAR findings showed a comparable high-risk cardiovascular risk profile for both sexes. Female patients were treated conservatively more often and received DAPT less often at discharge, with a shorter DAPT duration. ACS was more prevalent among male patients; however, overall clinical outcome was not different between male and female patients during follow-up.
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Affiliation(s)
- F Arslan
- Department of Cardiology, Vivantes Klinikum Am Urban, Berlin, Germany.
| | - I J Núñez-Gil
- Cardiovascular Institute, Hospital Clínico San Carlos, Madrid, Spain
- Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | | | | | - M Bollati
- Policlinico San Donato, Milan, Italy
| | - L Nombela-Franco
- Cardiovascular Institute, Hospital Clínico San Carlos, Madrid, Spain
| | - B Terol
- Hospital Severo Ochoa, Leganés, Spain
| | | | | | | | - I J Amat Santos
- CIBERCV, Cardiology Department, University Clinic Hospital, Valladolid, Spain
| | | | - I Pascual
- Hospital Central de Asturias, Oviedo, Spain
| | - C Liebetrau
- Department of Cardiology, Kerckhoff Heart Centre, Bad Nauheim, Germany
| | - M Alkhouli
- West Virginia University Heart and Vascular Institute, Morgantown, WV, USA
| | - A Fernández-Ortiz
- Cardiovascular Institute, Hospital Clínico San Carlos, Madrid, Spain
- Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
- Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain
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10
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D'Ascenzo F, Saglietto A, Ramakrishna H, Andreis A, Jiménez-Mazuecos JM, Nombela-Franco L, Cerrato E, Liebetrau C, Alfonso-Rodríguez E, Bagur R, Alkhouli M, De Ferrari GM, Núñez-Gil IJ. Usefulness of oral anticoagulation in patients with coronary aneurysms: Insights from the CAAR registry. Catheter Cardiovasc Interv 2021; 98:864-871. [PMID: 32902099 DOI: 10.1002/ccd.29243] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 08/08/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To assess the Usefulness of oral anticoagulation therapy (OAT) in patients with coronary artery aneurysm (CAA). BACKGROUND Data on the most adequate antithrombotic CAA management is lacking. METHODS Patients included in CAAR (Coronary Artery Aneurysm Registry, Clinical Trials.gov: NCT02563626) were selected. Patients were divided in OAT and non-OAT groups, according to anticoagulation status at discharge and 2:1 propensity score matching with replacement was performed. The primary endpoint of the analysis was a composite and mutual exclusive endpoint of myocardial infarction, unstable angina (UA), and aneurysm thrombosis (coronary ischemic endpoint). Net adverse clinical events, major adverse cardiovascular events, their single components, cardiovascular death, re-hospitalizations for heart failure, stroke, aneurysm thrombosis, and bleeding were the secondary ones. RESULTS One thousand three hundred thirty-one patients were discharged without OAT and 211 with OAT. In the propensity-matched sample (390 patients in the non-OAT group, 195 patients in the OAT group), after 3 years of median follow-up (interquartile range 1-6 years), the rate of the primary endpoint (coronary ischemic endpoint) was significantly less in the OAT group as compared to non-OAT group (8.7 vs. 17.2%, respectively; p = .01), driven by a significant reduction in UA (4.6 vs. 10%, p < .01) and aneurysm thrombosis (0 vs. 3.1%, p = .03), along with a non-significant reduction in MI (4.1 vs. 7.7%, p = .13). A non-significant increase in bleedings, mainly BARC type 1 (55%), was found in the OAT-group (10.3% in the non-OAT vs. 6.2% in the OAT group, p = .08). CONCLUSION OAT decreases the composite endpoint of UA, myocardial infarction, and aneurysm thrombosis in patients with CAA, despite a non-significant higher risk of bleeding.
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Affiliation(s)
- Fabrizio D'Ascenzo
- Cardiology, Città della Salute e della Scienza, Molinette Hospital, Torino, Italy
| | - Andrea Saglietto
- Cardiology, Città della Salute e della Scienza, Molinette Hospital, Torino, Italy
| | - Harish Ramakrishna
- Division of Cardiovascular Anesthesiology, Mayo Clinic Rochester, Arizona
| | - Alessandro Andreis
- Cardiology, Città della Salute e della Scienza, Molinette Hospital, Torino, Italy
| | | | | | - Enrico Cerrato
- Interventional Cardiology Unit, San Luigi Gonzaga University Hospital, Orbassano and Rivoli Infermi Hospital, Rivoli (Turin), Italy
| | - Christoph Liebetrau
- Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany.,Partner Site Rhein-Main, DZHK (German Centre for Cardiovascular Research), Frankfurt am Main, Germany
| | | | - Rodrigo Bagur
- Interventional Cardiology, University Hospital, London Health Sciences Centre, London, Ontario, Canada
| | | | - Gaetano M De Ferrari
- Cardiology, Città della Salute e della Scienza, Molinette Hospital, Torino, Italy
| | - Iván J Núñez-Gil
- Cardiovascular Institute, Hospital Clínico San Carlos, Madrid, Spain.,Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
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11
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Zhu X, Zhou Q, Tong S, Zhou Y. Challenges and strategies in the management of coronary artery aneurysms. Hellenic J Cardiol 2020; 62:112-120. [PMID: 32937198 DOI: 10.1016/j.hjc.2020.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/28/2020] [Accepted: 09/03/2020] [Indexed: 11/27/2022] Open
Abstract
Coronary artery aneurysms (CAAs) are infrequent but not rare. Because of the lack of supportive data and a substantial knowledge gap in this field, clinicians are in a dilemma how to manage patients with coronary artery aneurysms. Most often, CAAs are discovered incidentally, while symptomatic patients present with diverse complications of unstable angina, myocardial infarction, arrhythmias, or sudden cardiac death. Therapeutical approaches consist of surgical procedure, percutaneous coronary intervention (PCI), and medical management. Because of the scarcity of randomized trials or large-scale data on symptomatic and asymptomatic patients with coronary artery aneurysms, the management of these patients poses considerable challenges for the cardiologists. This review summarizes the current literature, a proposed algorithm for the management of CAAs is highlighted in the text. In view of the majority of current proposal information based on small series of case reports or observational studies, an individualized therapeutic regimen should be on the basis of the location, expansion by time, morphology, complications, and etiologies of the coronary artery aneurysms, the clinical presentations, and the patient's characteristics.
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Affiliation(s)
- Xiaogang Zhu
- Department of Cardiology, 12th Ward, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing 100029, China; Department of Cardiology, Fu Xing Hospital, Capital Medical University, Beijing 100038, China
| | - Quanzhong Zhou
- Department of Radiology, The Center for Medical Imaging of Guizhou Province, Affiliated Hospital of Zunyi Medical University, No. 149 Dalian Road, Huichuan District, Zunyi, Guizhou Province, 563000, China
| | - Shan Tong
- Department of Cardiology, 12th Ward, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing 100029, China
| | - Yujie Zhou
- Department of Cardiology, 12th Ward, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing 100029, China.
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12
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Lu CH, Fang CW, Chen HM, Fang YP, Fang CT, Huang YB, Chen CY, Liao KM, Yeh SCJ. Prescribing patterns of coronary artery aneurysm in Taiwan. BMC Cardiovasc Disord 2019; 19:188. [PMID: 31382884 PMCID: PMC6683534 DOI: 10.1186/s12872-019-1172-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 07/26/2019] [Indexed: 01/25/2023] Open
Abstract
Background Coronary artery aneurysm (CAA) is a rare disease, and there are limited data on prescribing patterns for CAA. The aim of our study was to investigate prescribing patterns for CAA in Taiwan via the National Health Insurance Research Database (NHIRD). Methods We included all CAA patients in Taiwan from 2005 to 2011. Data from 1 year before and after the CAA diagnosis were used to analyze examinations, comorbidities and prescribing patterns. Results A total of 1397 patients diagnosed with CAA were enrolled in our study. Most pediatric patients with CAA were diagnosed with Kawasaki disease (95.7%). In pediatric CAA patients, the utilization rates of aspirin and gamma globulins were 82.9 and 53.6%, respectively, after CAA diagnosis. Among the antithrombotic agents, aspirin was used most commonly, followed by dipyridamole (16.9%), heparin (5.8%) and warfarin (4.6%). In adult CAA patients, common comorbidities included hypertension (63.4%), hyperlipidemia (39.6%), and diabetes mellitus (26.1%). Coronary atherosclerosis was identified in 72.5% of adult patients after CAA diagnosis. Antithrombotic agents, particularly aspirin, clopidogrel and heparin, were prescribed more frequently after CAA diagnosis. Among the prescribed medications, aspirin (75.8%), β-blockers (48.3%), statins (47.6%), metformin (14.4%), sulfonylureas (14.4%) and isosorbide mononitrate (32.9%) were frequently observed in each category. Conclusions Kawasaki disease was the main cause of CAA in pediatric patients, and coronary artery disease was the most common comorbidity in adult CAA patients. The most commonly used antithrombic agent after CAA diagnosis was aspirin in both adult and pediatric patients.
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Affiliation(s)
- Chun-Hui Lu
- Division of Pharmacy, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan
| | - Chih-Wun Fang
- Division of Pharmacy, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan
| | - Hao-Ming Chen
- Division of Pharmacy, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan.,Division of Health Technology Assessment, Center for Drug Evaluation, Taipei, Taiwan
| | - Yi-Ping Fang
- School of Pharmacy, Kaohsiung Medical University, 100, Shiquan 1st Rd., Sanmin Dist.,, Kaohsiung City, 80708, Taiwan, Republic of China
| | - Chein-Tang Fang
- School of Pharmacy, Kaohsiung Medical University, 100, Shiquan 1st Rd., Sanmin Dist.,, Kaohsiung City, 80708, Taiwan, Republic of China
| | - Yaw-Bin Huang
- School of Pharmacy, Kaohsiung Medical University, 100, Shiquan 1st Rd., Sanmin Dist.,, Kaohsiung City, 80708, Taiwan, Republic of China.,Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chung-Yu Chen
- School of Pharmacy, Kaohsiung Medical University, 100, Shiquan 1st Rd., Sanmin Dist.,, Kaohsiung City, 80708, Taiwan, Republic of China. .,Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. .,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
| | - Kuang-Ming Liao
- Department of Internal Medicine, Chi Mei Medical Center, Chiali, No.606, Jialixing, Jiali Dist., Tainan City, 72263, Taiwan, Republic of China.
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13
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Núñez-Gil IJ, Cerrato E, Bollati M, Nombela-Franco L, Terol B, Alfonso-Rodríguez E, Camacho Freire SJ, Villablanca PA, Amat Santos IJ, de la Torre Hernández JM, Pascual I, Liebetrau C, Camacho B, Pavani M, Albistur J, Latini RA, Varbella F, Jiménez-Díaz VA, Piraino D, Mancone M, Alfonso F, Linares JA, Rodríguez-Olivares R, Jiménez Mazuecos JM, Palazuelos Molinero J, Sánchez-Grande Flecha A, Gomez-Hospital JA, Ielasi A, Lozano Í, Omedè P, Bagur R, Ugo F, Medda M, Louka BF, Kala P, Escaned J, Bautista D, Feltes G, Salinas P, Alkhouli M, Macaya C, Fernández-Ortiz A. Coronary artery aneurysms, insights from the international coronary artery aneurysm registry (CAAR). Int J Cardiol 2019; 299:49-55. [PMID: 31378382 DOI: 10.1016/j.ijcard.2019.05.067] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 05/13/2019] [Accepted: 05/27/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Coronary Aneurysms are a focal dilatation of an artery segment >1.5-fold the normal size of adjacent segments. Although some series have suggested a prevalence of 0.3-12%, data are lacking. In addition, they are not mentioned in practice guidelines. Our aim was investigate its prevalence, management and long-term outcomes. METHODS AND RESULTS The coronary artery aneurysm registry (CAAR) involved 32 hospitals across 9 countries in America and Europe. We reviewed 436,467 consecutive angiograms performed over the period 2004-2016. Finally, 1565 patients were recruited. Aneurysm global prevalence was 0.35%. Most patients were male (78.5%) with a mean age of 65 years and frequent cardiovascular risk factors. The main indication for angiogram was an acute coronary syndrome, 966 cases. The number of aneurisms was ≤2 per patient in 95.8% of the cases, mostly saccular, most frequently found in the left anterior descending and with numbers proportional with coronary stenosis. Aortopathies were related with more aneurysms too. Most patients received any revascularization procedure (69%), commonly percutaneous (53%). After a median follow-up of 37.2 months, 485 suffered a combined event (MACE) and 240 died. Without major differences comparing CABG vs PCI, MACE and death were more frequent in patients who received bare metal stents. CONCLUSIONS Coronary artery aneurysms are not uncommon. Usually, they are associated with coronary stenosis and high cardiovascular risk. Antiplatelet therapy seems reasonable and a percutaneous approach is safe and effective.
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Affiliation(s)
- Iván J Núñez-Gil
- Cardiovascular Institute, Hospital Clínico San Carlos, Madrid, Spain; Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
| | - Enrico Cerrato
- Interventional Cardiology, Infermi Hospital, Rivoli, Turin, Italy
| | - Mario Bollati
- Interventional Cardiology, Policlinico San Donato, Milan, Italy
| | | | - Belén Terol
- Cardiology Department, Hospital Severo Ochoa, Leganés, Spain
| | | | | | - Pedro A Villablanca
- Interventional Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, USA
| | - Ignacio J Amat Santos
- CIBERCV, Interventional Cardiology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | | | - Isaac Pascual
- Department of Cardiology, Hospital Universitario Central de Asturias, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias, ISPA, Oviedo, Spain; University of Oviedo, Oviedo, Spain
| | - Christoph Liebetrau
- Kerckhoff Heart and Thorax Center, Department of Cardiology, Bad Nauheim, Germany; DZHK (German Centre for Cardiovascular Research), partner site Rhein-Main, Frankfurt am Main, Germany
| | - Benjamín Camacho
- Interventional Cardiology, Hospital Arnau de Vilanova, Lérida, Spain
| | - Marco Pavani
- Cardiology, Città della Salute e della Scienza, Molinnette II, Torino, Italy
| | - Juan Albistur
- Cardiology, Hospital de Clínicas Dr, Manuel Quintela, Montevideo, Uruguay
| | | | | | | | - Davide Piraino
- UO di Cardiologia Interventistica ed Emodinamica, Azienda Ospedaliera Universitaria Policlinico "P,Giaccone" Palermo, Italy
| | - Massimo Mancone
- Is Sapienza University of Rome, Policlinico Umberto I. Department of Cardiovascular, Respiratory, Neurological, Anaesthesiology and Geriatric Sciences
| | - Fernando Alfonso
- Cardiology Department, Hospital Universitario de La Princesa, Madrid, Spain
| | | | | | | | | | | | | | - Alfonso Ielasi
- Cardiology Division, ASST Bergamo Est, Bolognini Hospital Seriate, Italy
| | - Íñigo Lozano
- Interventional Cardiology, Hospital de Cabueñes, Gijon, Spain
| | - Pierluigi Omedè
- Cardiology, Città della Salute e della Scienza, Molinnette I, Torino, Italy
| | - Rodrigo Bagur
- Interventional Cardiology, University Hospital, London Health Sciences Centre, London, Ontario, Canada
| | - Fabrizio Ugo
- Interventional Cardiology, H San Giovanni Bosco, Turin, Italy
| | - Massimo Medda
- Interventional Cardiology Unit, Istituto Clinico Sant'Ambrogio, Milan, Italy
| | - Boshra F Louka
- Division of Cardiovascular Diseases, Mayo Clinic Arizona, USA
| | - Petr Kala
- Department of Internal Medicine and Cardiology, University Hospital Brno and Medical Faculty of Masaryk University, Brno, Czech Republic
| | - Javier Escaned
- Cardiovascular Institute, Hospital Clínico San Carlos, Madrid, Spain; Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Daniel Bautista
- Cardiology, Instituto dominicano de Cardiología, Santo Domingo, Dominican Republic
| | - Gisela Feltes
- Cardiovascular Institute, Hospital Clínico San Carlos, Madrid, Spain
| | - Pablo Salinas
- Cardiovascular Institute, Hospital Clínico San Carlos, Madrid, Spain
| | - Mohamad Alkhouli
- Cardiology, West Virginia University Heart and Vascular Institute, Morgantown, WV, United States of America
| | - Carlos Macaya
- Cardiovascular Institute, Hospital Clínico San Carlos, Madrid, Spain; Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Antonio Fernández-Ortiz
- Cardiovascular Institute, Hospital Clínico San Carlos, Madrid, Spain; Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
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14
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Kawsara A, Núñez Gil IJ, Alqahtani F, Moreland J, Rihal CS, Alkhouli M. Management of Coronary Artery Aneurysms. JACC Cardiovasc Interv 2018; 11:1211-1223. [DOI: 10.1016/j.jcin.2018.02.041] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 01/07/2018] [Accepted: 02/20/2018] [Indexed: 01/11/2023]
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15
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Núñez-Gil IJ, Nombela-Franco L, Bagur R, Bollati M, Cerrato E, Alfonso E, Liebetrau C, De la Torre Hernandez JM, Camacho B, Mila R, Amat-Santos IJ, Alfonso F, Rodríguez-Olivares R, Camacho Freire SJ, Lozano Í, Jiménez Díaz VA, Piraino D, Latini RA, Feltes G, Linares JA, Mancone M, Ielasi A, Sánchez-Grande Flecha A, Fernández Cisnal A, Ugo F, Jiménez Mazuecos JM, Omedè P, Pavani M, Villablanca PA, Louka BF, Fernández-Ortiz A. Rationale and design of a multicenter, international and collaborative Coronary Artery Aneurysm Registry (CAAR). Clin Cardiol 2017; 40:580-585. [PMID: 28337781 DOI: 10.1002/clc.22705] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 01/22/2017] [Accepted: 02/15/2017] [Indexed: 11/09/2022] Open
Abstract
Coronary artery aneurysm is defined as a coronary dilation that exceeds the diameter of adjacent segments or the diameter of the patient's largest normal coronary vessel by 1.5×. It is an uncommon disease that has been diagnosed with increasing frequency since the widespread appearance of coronary angiography. The published incidence varies from 1.5% to 5%, suggesting male dominance and a predilection for the right coronary artery. Although several causes have been described, atherosclerosis accounts for ≥50% of coronary aneurysms in adults. Reported complications include thrombosis and distal embolization, rupture, and vasospasm, causing ischemia, heart failure, or arrhythmias. The natural history and prognosis remain unknown, as definitive data are scarce. Controversies persist regarding the use of medical management (antithrombotic therapy) or interventional/surgical procedures. Only some case reports or small case series are available about this condition. The Coronary Artery Aneurysm Registry (CAAR; http://www.ClinicalTrials.gov NCT02563626) is a multicenter international ambispective registry that aims to provide insights on anatomic, epidemiologic, and clinical aspects of this substantially unknown entity. In addition, the registry will assess management strategies (conservative, interventional, or surgical) and their short- and long-term results in a large cohort of patients. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov. Unique identifier: NCT02563626.
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Affiliation(s)
- Iván J Núñez-Gil
- Cardiovascular Institute, Hospital Clínico San Carlos and Department of Medicine, Complutense University, Madrid, Spain
| | - Luis Nombela-Franco
- Cardiovascular Institute, Hospital Clínico San Carlos and Department of Medicine, Complutense University, Madrid, Spain
| | - Rodrigo Bagur
- Division of Cardiology, Department of Medicine, London Health Sciences Centre, and Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
| | - Mario Bollati
- Department of Interventional Cardiology, SS Annanziata Hospital, Savigliano, Italy
| | - Enrico Cerrato
- Interventional Unit, San Luigi Gonzaga University Hospital, Orbassano and Infermi HOspital, Rivoli (Turin), Italy
| | - Emilio Alfonso
- Instituto de Cardiología y Cirugía Cardiovascular, La Habana, Cuba
| | - Christoph Liebetrau
- Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany; DZHK (German Centre for Cardiovascular Research), partner site Rhein-Main, Frankfurt am Main, Germany
| | | | - Benjamín Camacho
- Department of Interventional Cardiology, Hospital Arnau de Vilanova, Lérida, Spain
| | - Rafael Mila
- Department of Cardiology, Hospital de Clínicas Dr. Manuel Quintela, Montevideo, Uruguay
| | - Ignacio J Amat-Santos
- Department of Interventional Cardiology, Hospital Clínico Universitario de Valladolid, Spain
| | - Fernando Alfonso
- Department of Cardiology, Hospital Universitario de La Princesa, Madrid, Spain
| | | | | | - Íñigo Lozano
- Department of Interventional Cardiology, Hospital de Cabueñes, Gijon, Spain
| | | | - Davide Piraino
- UO di Cardiologia Interventistica ed Hemodinámica, Azienda Ospedaliera Universitaria Policlinico "P. Giaccone,", Palermo, Italy
| | | | - Gisela Feltes
- Cardiovascular Institute, Hospital Clínico San Carlos and Department of Medicine, Complutense University, Madrid, Spain
| | | | - Massimo Mancone
- Department of Interventional Cardiology, Hospital La Sapienza, Rome, Italy
| | | | | | | | - Fabrizio Ugo
- Department of Interventional Cardiology, Hospital San Giovanni Bosco, Turin, Italy
| | | | - Pierluigi Omedè
- Department of Cardiology, Città della Salute e della Scienza I, Turin, Italy
| | - Marco Pavani
- Department of Cardiology, Città della Salute e della Scienza II, Turin, Italy
| | - Pedro A Villablanca
- Department of Interventional Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, New York City, New York
| | - Boshra F Louka
- Division of Cardiovascular Diseases, Mayo Clinic, Phoenix, Arizona
| | - Antonio Fernández-Ortiz
- Cardiovascular Institute, Hospital Clínico San Carlos and Department of Medicine, Complutense University, Madrid, Spain
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