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Aslan EI, Ozkara G, Kilicarslan O, Ser OS, Bostan C, Yildiz A, Diren Borekcioglu A, Ozturk O, Kucukhuseyin O, Yilmaz Aydogan H. Receptor for advanced glycation end products polymorphisms in coronary artery ectasia. Gene 2024; 916:148450. [PMID: 38588932 DOI: 10.1016/j.gene.2024.148450] [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] [Received: 10/21/2023] [Revised: 03/15/2024] [Accepted: 04/05/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Although the implication of receptor of advanced glycation endproducts (RAGE) has been reported in coronary artery disease, its roles in coronary artery ectasia (CAE) have remained undetermined. Furthermore, the effect of RAGE polymorfisms were not well-defined in scope of soluble RAGE (sRAGE) levels. Thus, we aimed to investigate the influence of the functional polymorphisms of RAGE -374T > A (rs1800624) and G82S (rs2070600) in CAE development. METHODS This prospective observational study was conducted in 2 groups selected of 2452 patients who underwent elective coronary angiography (CAG) for evaluation after positive noninvasive heart tests. Group-I included 98 patients with non-obstructive coronary artery disease and CAE, and Group-II (control) included 100 patients with normal coronary arteries. SNPs were genotyped by real-time PCR using Taqman® genotyping assay. Serum sRAGE and soluble lectin-like oxidized receptor-1 (sOLR1) were assayed by ELISA and serum lipids were measured enzymatically. RESULTS The frequencies of the RAGE -374A allele and -374AA genotype were significantly higher in CAE patients compared to controls (p < 0.001). sRAGE levels were not different between study groups, while sOLR1 levels were elevated in CAE (p = 0.004). In controls without systemic disease, -374A allele was associated with low sRAGE levels (p < 0.05), but this association was not significant in controls with HT. Similarly, sRAGE levels of CAE patients with both HT and T2DM were higher than those no systemic disease (p = 0.02). The -374A allele was also associated with younger patient age and higher platelet count in the CAE group in both total and subgroup analyses. In the correlation analyses, the -374A allele was also negatively correlated with age and positively correlated with Plt in all of these CAE groups. In the total CAE group, sRAGE levels also showed a positive correlation with age and a negative correlation with HDL-cholesterol levels. On the other hand, a negative correlation was observed between sRAGE and Plt in the total, hypertensive and no systemic disease control subgroups. Multivariate logistic regression analysis confirmed that the -374A allele (p < 0.001), hyperlipidemia (p < 0.05), and high sOLR1 level (p < 0.05) are risk factors for CAE. ROC curve analysis shows that RAGE -374A allele has AUC of 0.713 (sensitivity: 83.7 %, specificity: 59.0 %), which is higher than HLD (sensitivity: 59.2 %, specificity: 69.0 %), HT (sensitivity: 62.4 %, specificity: 61.1 %) and high sOLR1 level (≥0.67 ng/ml)) (sensitivity: 59.8 %, specificity: 58.5 %). CONCLUSION Beside the demonstration of the relationship between -374A allele and increased risk of CAE for the first time, our results indicate that antihypertensive and antidiabetic treatment in CAE patients causes an increase in sRAGE levels. The lack of an association between the expected -374A allele and low sRAGE levels in total CAE group was attributed to the high proportion of hypertensive patients and hence to antihypertensive treatment. Moreover, the RAGE -374A allele is associated with younger age at CAE and higher Plt, suggesting that -374A may also be associated with platelet activation, which plays a role in the pathogenesis of CAE. However, our data need to be confirmed in a large study for definitive conclusions.
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Affiliation(s)
- Ezgi Irmak Aslan
- Department of Molecular Medicine, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey; Department of Medical Biochemistry, Faculty of Medicine, Istanbul Nisantasi University, Istanbul, Turkey.
| | - Gulcin Ozkara
- Department of Molecular Medicine, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey; Department of Medical Biology, Bezmialem Vakıf University, Istanbul, Turkey.
| | - Onur Kilicarslan
- Department of Cardiology, Institute of Cardiology, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Ozgur Selim Ser
- Department of Cardiology, Institute of Cardiology, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Cem Bostan
- Department of Cardiology, Institute of Cardiology, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Ahmet Yildiz
- Department of Cardiology, Institute of Cardiology, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Ayca Diren Borekcioglu
- Department of Molecular Medicine, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey.
| | - Oguz Ozturk
- Department of Molecular Medicine, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey.
| | - Ozlem Kucukhuseyin
- Department of Molecular Medicine, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey.
| | - Hulya Yilmaz Aydogan
- Department of Molecular Medicine, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey.
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Ozkara G, Aslan EI, Malikova F, Aydogan C, Ser OS, Kilicarslan O, Dalgic SN, Yildiz A, Ozturk O, Yilmaz-Aydogan H. Endothelin-converting Enzyme-1b Genetic Variants Increase the Risk of Coronary Artery Ectasia. Biochem Genet 2024:10.1007/s10528-024-10810-9. [PMID: 38625594 DOI: 10.1007/s10528-024-10810-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 04/09/2024] [Indexed: 04/17/2024]
Abstract
Coronary artery ectasia (CAE), defined as a 1.5-fold or greater enlargement of a coronary artery segment compared to the adjacent normal coronary artery, is frequently associated with atherosclerotic coronary artery disease (CAD). Membrane-bound endothelin converting enzyme-1 (ECE-1) is involved in the maturation process of the most potent vasoconstrictor ET-1. Polymorphisms in the endothelin (ET) gene family have been shown associated with the development of atherosclerosis. This study aims to investigate the effects of rs213045 and rs2038089 polymorphisms in the ECE-1 gene which have been previously shown to be associated with atherosclerosis and hypertension (HT), in CAE patients. Ninety-six CAE and 175 patients with normal coronary arteries were included in the study. ECE-1b gene variations rs213045 and rs2038089 were determined by real-time PCR. The frequencies of rs213045 C > A (C338A) CC genotype (60.4% vs. 35.4%, p < 0.001) and rs2038089 T > C T allele (64.58% vs. 35.42%, p = 0.017) were higher in the CAE group compared to the control group. The multivariate regression analysis showed that the ECE-1b rs213045 CC genotype (p = 0.001), rs2038089 T allele (p = 0.017), and hypercholesterolemia (HC) (p = 0.001) are risk factors for CAE. Moreover, in nondiabetic individuals of the CAE and control groups, it was observed that the rs213045 CC genotype (p < 0.001), and rs2038089 T allele (p = 0.003) were a risk factor for CAE, but this relationship was not found in the diabetic subgroups of the study groups (p > 0.05). These results show that ECE-1b polymorphisms may be associated with the risk of CAE and this relationship may change according to the presence of type II diabetes.
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Affiliation(s)
- Gulcin Ozkara
- Department of Molecular Medicine, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey.
- Department of Medical Biology, Bezmialem Vakif University, Faculty of Medicine, Topkapi Mahallesi, Adnan Menderes Vatan Bulvari, No:113, Istanbul, Turkey.
| | - Ezgi Irmak Aslan
- Department of Molecular Medicine, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey
- Department of Medical Biochemistry, Istanbul Nisantasi University, Faculty of Medicine, Istanbul, Turkey
| | - Fidan Malikova
- Department of Molecular Medicine, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey
| | - Cagatay Aydogan
- Department of Molecular Medicine, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey
| | - Ozgur Selim Ser
- Department of Cardiology, Institute of Cardiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Onur Kilicarslan
- Department of Cardiology, Institute of Cardiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Sadiye Nur Dalgic
- Department of Cardiology, Institute of Cardiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ahmet Yildiz
- Department of Cardiology, Institute of Cardiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Oguz Ozturk
- Department of Molecular Medicine, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey
| | - Hulya Yilmaz-Aydogan
- Department of Molecular Medicine, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey
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Toprak K, Kaplangoray M, Altiparmak İH, Taşcanov MB, Güngören F, Fedai H, İnanir M, Biçer A, Demirbağ R. Can increased intestinal permeability and low-grade endotoxemia be the triggering pathogenesis in isolated coronary artery ectasia? Coron Artery Dis 2023; 34:102-110. [PMID: 36720018 DOI: 10.1097/mca.0000000000001209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
PURPOSE Isolated coronary artery ectasia (ICAE) is a rare coronary artery disease (CAD) encountered during coronary angiography. Although many mechanisms have been suggested today that may be associated with ICAE, the underlying pathogenesis has not been fully understood. In this study, we aimed to reveal the possible relationship between intestinal permeability and ICAE. METHODS Of the 12 850 patients who underwent coronary angiography, 138 consecutive patients with ICAE and 140 age- and sex-matched subjects with normal coronary arteries as the control group and 140 subjects with stenotic CAD were included in the study. RESULTS Serum zonulin and lipopolysaccharide levels were significantly higher in patients with ICAE than in the control group and CAD group. Additionally, zonulin and lipopolysaccharide levels were significantly higher in the CAD group than in the ICAE group. In the correlation analysis, serum zonulin levels were correlated with the mean diameter and length of the ecstatic segment. In multivariate analysis, zonulin and lipopolysaccharide were identified as independent predictors for ICAE. CONCLUSION These results suggest that there may be a pathophysiological relationship between increased intestinal permeability and ICAE.
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Affiliation(s)
- Kenan Toprak
- Department of Cardiology, Faculty of Medicine, Harran University
| | - Mustafa Kaplangoray
- Department of Cardiology, Mehmet Akif İnan Training and Research Hospital, Sanliurfa
| | | | | | - Fatih Güngören
- Department of Cardiology, Istanbul Aydin University VM Medical Park Florya Hospital, Istanbul
| | - Halil Fedai
- Department of Cardiology, Şanliurfa Training and Research Hospital, Sanliurfa
| | - Mehmet İnanir
- Department of Cardiology, Bolu Abant Izzet Baysal University, Medical Faculty, Cardiology Department, Bolu, Turkey
| | - Asuman Biçer
- Department of Cardiology, Faculty of Medicine, Harran University
| | - Recep Demirbağ
- Department of Cardiology, Faculty of Medicine, Harran University
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Esposito L, Di Maio M, Silverio A, Cancro FP, Bellino M, Attisano T, Tarantino FF, Esposito G, Vecchione C, Galasso G, Baldi C. Treatment and Outcome of Patients With Coronary Artery Ectasia: Current Evidence and Novel Opportunities for an Old Dilemma. Front Cardiovasc Med 2022; 8:805727. [PMID: 35187112 PMCID: PMC8854288 DOI: 10.3389/fcvm.2021.805727] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 12/27/2021] [Indexed: 12/19/2022] Open
Abstract
Coronary artery ectasia (CAE) is defined as a diffuse or focal dilation of an epicardial coronary artery, which diameter exceeds by at least 1. 5 times the normal adjacent segment. The term ectasia refers to a diffuse dilation, involving more than 50% of the length of the vessel, while the term aneurysm defines a focal vessel dilation. CAE is a relatively uncommon angiographic finding and its prevalence ranges between 0.3 and 5% of patients undergoing coronary angiography. Although its pathophysiology is still unclear, atherosclerosis seems to be the underlying mechanism in most cases. The prognostic role of CAE is also controversial, but previous studies reported a high risk of cardiovascular events and mortality in these patients after percutaneous coronary intervention. Despite the availability of different options for the interventional management of patients with CAE, including covered stent implantation and stent-assisted coil embolization, there is no one standard approach, as therapy is tailored to the individual patient. The abnormal coronary dilation, often associated with high thrombus burden in the setting of acute coronary syndromes, makes the interventional treatment of CAE patients challenging and often complicated by distal thrombus embolization and stent malapposition. Moreover, the optimal antithrombotic therapy is debated and includes dual antiplatelet therapy, anticoagulation, or a combination of them. In this review we aimed to provide an overview of the pathophysiology, classification, clinical presentation, natural history, and management of patients with CAE, with a focus on the challenges for both clinical and interventional cardiologists in daily clinical practice.
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Affiliation(s)
- Luca Esposito
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
- *Correspondence: Luca Esposito
| | - Marco Di Maio
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Angelo Silverio
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | | | - Michele Bellino
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Tiziana Attisano
- Division of Interventional Cardiology, Cardiovascular and Thoracic Department, San Giovanni di Dio e Ruggi, Salerno, Italy
| | | | - Giovanni Esposito
- Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy
| | - Carmine Vecchione
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
- Vascular Pathophysiology Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Neuromed, Pozzilli, Italy
| | - Gennaro Galasso
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Cesare Baldi
- Division of Interventional Cardiology, Cardiovascular and Thoracic Department, San Giovanni di Dio e Ruggi, Salerno, Italy
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5
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Uysal BA, Kuyumcu MS. Serum irisin and adropin levels may be predictors for coronary artery ectasia. Clin Exp Hypertens 2022; 44:223-227. [PMID: 34994255 DOI: 10.1080/10641963.2021.2018601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND There is strong evidence that oxidative stress and inflammation may contribute to the coronary artery ectasia (CAE) pathophysiology. Recent studies have shown that serum irisin and adropin levels are associated with oxidative stress and inflammation. In the light of this information, we aimed to investigate the possible relationship between serum irisin, adropin levels and CAE. PATIENTS & METHODS A total of 50 consecutive patients with CAE and 50 consecutive patients with normal coronary anatomy (NCA) were enrolled into the study. Serum irisin, adropin and other clinical parameters were compared between groups. RESULTS Adropin (p < .001) and irisin (p < .001) levels were lower in the CAE group. Low adropin (p = .014) and irisin (p < .001) levels were detected as an independent risk factor for CAE in multiple regression analysis. Receiver operating characteristic curve analysis showed that serum adropin (p < .001) and irisin (p < .001) leves was significant predictor of CAE. CONCLUSIONS The results of this study showed that serum irisin and adropin level was lower in the CAE group than in the NCA group. Irisin and adropin could play a role in the pathogenesis of CAE.
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Affiliation(s)
- Bayram Ali Uysal
- Faculty of Medicine, Department of Cardiology, Suleyman Demirel University, Isparta, Turkey
| | - Mevlut Serdar Kuyumcu
- Faculty of Medicine, Department of Cardiology, Suleyman Demirel University, Isparta, Turkey
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Parvathareddy KKR, Maale S, Nagula P, Ravi S, Rayapu M, Balla NR. Clinical and angiographic characteristics of coronary artery ectasia and its correlation with high-sensitivity c-reactive protein and serum uric acid. JOURNAL OF THE PRACTICE OF CARDIOVASCULAR SCIENCES 2022. [DOI: 10.4103/jpcs.jpcs_24_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Liu T, Sun Y, Li H, Xu H, Xiao N, Wang X, Song L, Bai C, Wen H, Ge J, Zhang Y, Song W, Chen J. Metabolomic Characterization of Fatty Acids in Patients With Coronary Artery Ectasias. Front Physiol 2021; 12:770223. [PMID: 34867478 PMCID: PMC8640203 DOI: 10.3389/fphys.2021.770223] [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] [Received: 09/03/2021] [Accepted: 10/21/2021] [Indexed: 11/13/2022] Open
Abstract
Background: We used a targeted metabolomics approach to identify fatty acid (FA) metabolites that distinguished patients with coronary artery ectasia (CAE) from healthy Controls and patients with coronary artery disease (CAD). Materials and methods: Two hundred fifty-two human subjects were enrolled in our study, such as patients with CAE, patients with CAD, and Controls. All the subjects were diagnosed by coronary angiography. Plasma metabolomic profiles of FAs were determined by an ultra-high-performance liquid chromatography coupled to triple quadrupole mass spectrometric (UPLC-QqQ-MS/MS). Results: Ninety-nine plasma metabolites were profiled in the discovery sets (n = 72), such as 35 metabolites of arachidonic acid (AA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA), 10 FAs, and 54 phospholipids. Among these metabolites, 36 metabolites of AA, EPA, and DHA showed the largest difference between CAE and Controls or CAD. 12-hydroxyeicosatetraenoic acid (12-HETE), 17(S)-hydroxydocosahexaenoic acid (17-HDoHE), EPA, AA, and 5-HETE were defined as a biomarker panel in peripheral blood to distinguish CAE from CAD and Controls in a discovery set (n = 72) and a validation set (n = 180). This biomarker panel had a better diagnostic performance than metabolite alone in differentiating CAE from Controls and CAD. The areas under the ROC curve of the biomarker panel were 0.991 and 0.836 for CAE versus Controls and 1.00 and 0.904 for CAE versus CAD in the discovery and validation sets, respectively. Conclusions: Our findings revealed that the metabolic profiles of FAs in the plasma from patients with CAE can be distinguished from those of Controls and CAD. Differences in FAs metabolites may help to interpret pathological mechanisms of CAE.
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Affiliation(s)
- Tianlong Liu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Department of Pharmacy, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Yingying Sun
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hao Li
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Haochen Xu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ning Xiao
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xuliang Wang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Li Song
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Congxia Bai
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hongyan Wen
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Ge
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yinhui Zhang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Weihua Song
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jingzhou Chen
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Wang X, Montero-Cabezas JM, Mandurino-Mirizzi A, Hirasawa K, Ajmone Marsan N, Knuuti J, Bax JJ, Delgado V. Prevalence and Long-term Outcomes of Patients with Coronary Artery Ectasia Presenting with Acute Myocardial Infarction. Am J Cardiol 2021; 156:9-15. [PMID: 34344511 DOI: 10.1016/j.amjcard.2021.06.037] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/11/2021] [Accepted: 06/15/2021] [Indexed: 12/11/2022]
Abstract
Coronary artery ectasia (CAE) is described in 5% of patients undergoing coronary angiography. Previous studies have shown controversial results regarding the prognostic impact of CAE. The prevalence and prognostic value of CAE in patients with acute myocardial infarction (AMI) remain unknown. In 4788 patients presenting with AMI referred for coronary angiography the presence of CAE (defined as dilation of a coronary segment with a diameter ≥1.5 times of the adjacent normal segment) was confirmed in 174 (3.6%) patients (age 62 ± 12 years; 81% male), and was present in the culprit vessel in 79.9%. Multivessel CAE was frequent (67%). CAE patients were more frequently male, had high thrombus burden and were treated more often with thrombectomy and less often was stent implantation. Markis I was the most frequent angiographic phenotype (43%). During a median follow-up of 4 years (1-7), 1243 patients (26%) experienced a major adverse cardiovascular event (MACE): 282 (6%) died from a cardiac cause, 358 (8%) had a myocardial infarction, 945 (20%) underwent coronary revascularization and 58 (1%) presented with a stroke. Patients with CAE showed higher rates of MACE as compared to those without CAE (36.8% versus 25.6%; p <0.001). On multivariable analysis, CAE was associated with MACE (HR 1.597; 95% CI 1.238-2.060; p <0.001) after adjusting for risk factors, type of AMI and number of narrowed coronary arteries. In conclusion, the prevalence of CAE in patients presenting with AMI is relatively low but was independently associated with an increased risk of MACE at follow-up.
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Affiliation(s)
- Xu Wang
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing, China
| | | | - Alessandro Mandurino-Mirizzi
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; Division of Cardiology, Foundation IRCCS Policlinico San Matteo, Pavia, Italy
| | - Kensuke Hirasawa
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Nina Ajmone Marsan
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Juhani Knuuti
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; Heart Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Jeroen J Bax
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; Heart Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Victoria Delgado
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
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Cuglan B, Ozturk S, Ozcan F, Atmaca H, Ensaroğlu F, Saçıkara A, Yetkin E. Assessment of venous leg symptoms in patients with hemorrhoidal disease (VEIN-HEMORRHOID study). Phlebology 2021; 37:42-47. [PMID: 34496696 DOI: 10.1177/02683555211030734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Coexistence of dilating venous diseases in different vascular territories has raised the idea that they have similar vascular wall abnormality in their evolutionary process. Accordingly, we aimed to evaluate venous leg symptoms in patients with hemorrhoidal disease (HD) by means of VEINES-Sym questionnaire. MATERIALS AND METHODS The study involved 249 consecutive patients who underwent colonoscopy and met the inclusion criteria. Presence and grading of HD were made according to Goligher's classification. All patients were examined for the existing of varicose vein and classified in respect of CEAP classification. All participants were requested to answer the VEINES-Sym questionnaire. RESULTS There was not statistically significant differences between the patients without HD (grade 0 or I) and with HD (Grade II or III) in respect to clinical characteristics except female predominance in hemorrhoid group (p = 0.07). Scores of heavy legs, swelling, burning sensation, restless leg, throbbing, tingling, and total VEINES score were significantly lower (ie: worse) in hemorrhoid group. Logistic regression analysis revealed that female gender and total VEINES score were independently associated with HD (OR: 2.03, 95% CI: 1.17-3.52, p = 0.01; OR: 0.96, 95% CI: 0.92-0.99, p = 0.02, respectively). Among all venous leg symptoms, severity of heavy legs, night cramps, swelling and aching were significantly correlated with the grades of HD. CONCLUSION We have shown significant association between the HD and venous leg symptoms reflected by total VEINES score and significant correlation between the HD grade and venous leg symptoms severity including heavy legs, swelling, night cramps and aching legs.
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Affiliation(s)
- Bilal Cuglan
- Faculty of Medicine, Department of Cardiology, Beykent University, Istanbul, Turkey
| | - Selcuk Ozturk
- Faculty of Medicine, Department of Cardiology, Bozok University, Yozgat, Turkey
| | - Fulya Ozcan
- Department of General Surgery, Private Derindere Hospital, Istanbul, Turkey
| | - Hasan Atmaca
- Private Okmeydanı Medical Center, Cardiology Clinic, Istanbul, Turkey
| | - Fatih Ensaroğlu
- Department of Gastroenterology, Istinye University Liv Hospital, Istanbul, Turkey
| | - Alparslan Saçıkara
- Private Okmeydanı Medical Center, Gastroenterology Clinic, Istanbul, Turkey
| | - Ertan Yetkin
- Department of Cardiology, Private Derindere Hospital, Istanbul, Turkey
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10
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Wei W, Wang X, Huang Z, Li X, Luo Y. Difference in inflammation, atherosclerosis, and platelet activation between coronary artery aneurysm and coronary artery ectasia. J Thorac Dis 2020; 12:5811-5821. [PMID: 33209413 PMCID: PMC7656333 DOI: 10.21037/jtd-20-1579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Background Coronary artery aneurysm (CAA) and coronary artery ectasia (CAE) may be two different types of coronary artery dilatation with unknown etiology. This study aimed to compare the differences between CAA and CAE and to investigate their pathogenesis and the necessity of antiplatelet therapy. Methods One hundred patients each with confirmed CAA, CAE, and normal coronary artery (NCA) from September 2017 to July 2019 were included. All patients completed examinations of the ankle-brachial index (ABI), pulse wave rate, and carotid ultrasonography; and were tested for routine blood, lipid, and immune parameters. Blood samples were collected 1 week after the withdrawal of antiplatelet drugs, and vascular inflammatory indexes, platelet activation indexes, thromboelastography, and the platelet aggregation rate were measured. Analysis of variance and the chi-square or Fisher exact test were used for statistical analysis. Results The perinuclear anti-neutrophil cytoplasmic antibody (ANCA), endothelial-1, matrix metalloproteinase-9, and tumor necrosis factor-α were significantly higher in CAE than in NCA, while cytoplasmic ANCA was appreciably higher in CAE than in CAA (P<0.05). Myeloperoxidase and growth/differentiation factor-15 were significantly higher in CAE than in CAA and NCA (P<0.05). ABI was significantly lower in CAA and CAE than in NCA (P<0.05), low-density lipoprotein/high-density lipoprotein was significantly higher in CAA than in NCA (P<0.05), and the detection rate of carotid artery thickening was significantly higher in CAA than in CAE and NCA (P<0.05). The Gensini and SYNTAX scores were significantly higher in CAA than in CAE (P<0.05). The percentages of CD62P and PAC-1 were higher in CAA and CAE than in NCA (P<0.05). The arachidonic acid aggregation rate in CAA and adenosine 5'-diphosphate aggregation rate in CAE were significantly higher than in NCA (P<0.05). The values of thrombin formation time and reaction time were significantly lower in CAE than in NCA (P<0.05), and the α angle was significantly higher in CAE than in NCA. Conclusions CAE was closely related to inflammation, whereas CAA was closely related to atherosclerosis. Platelet activation was present in both diseases; therefore, antiplatelet therapy is recommended.
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Affiliation(s)
- Wei Wei
- Department of Cardiovascular Medicine, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xingxu Wang
- Department of Cardiovascular Medicine, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Zhenghao Huang
- Department of Cardiovascular Medicine, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiaolin Li
- Department of Cardiovascular Medicine, Jian East Hospital, Jinggangshan University School of Medicine, Jiangxi, China
| | - Yu Luo
- Department of Cardiovascular Medicine, East Hospital, Tongji University School of Medicine, Shanghai, China
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11
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Sheng Q, Zhao H, Wu S, Liu R. Underlying factors relating to acute myocardial infarction for coronary artery ectasia patients. Medicine (Baltimore) 2020; 99:e21983. [PMID: 32899042 PMCID: PMC7478456 DOI: 10.1097/md.0000000000021983] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Coronary artery ectasia (CAE) patients were more prone to present with acute myocardial infarction (AMI), this case-control research aimed to explore the underlying factors relating AMI for them.This study investigated a serial of 119 patients who underwent coronary angiography and were diagnosed as CAE between the years 2016 and 2017 at the Beijing Friendship Hospital; 32 of the patients developed AMI and 87 did not develop AMI. The possible factors relating to AMI, including disease history, cardiovascular risk factors, thrombotic condition, inflammation status, and coronary imaging characteristics, were comprehensively compared between CAE patients with and without AMI.CAE patients with AMI had a lower antiplatelet rate, a higher blood low-density lipoprotein cholesterol level, increased neutrophil to lymphocyte (NL) ratio, higher Gensini score, and larger proportions of Markis type II. Logistic regression analysis also indicated that AMI history, lower antiplatelet rate, higher NL ratio, higher low-density lipoprotein cholesterol level and Gensini score, as well as Markis type II were associated with AMI in CAE patients.AMI history, lower antiplatelet treatment rates, poor blood lipid control and higher coronary stenosis extent, higher inflammatory response, and Markis type II were closely related to the incidence of AMI in CAE patients.
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12
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Soltani D, Jafari S, Ashraf H, Sobh-Rakhshankhah A, Kolahchi Z, Masoudkabir F, Boroumand MA, Vasheghani-Farahani A. Ratio of Serum Aspartate to Alanine Aminotransferase as a Marker of Isolated Coronary Artery Ectasia and its Severity. Heart Int 2020; 14:43-48. [PMID: 36277666 PMCID: PMC9524754 DOI: 10.17925/hi.2020.14.1.43] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 04/27/2020] [Indexed: 04/24/2024] Open
Abstract
BACKGROUND Several studies have reported an association between elevated liver enzymes and increased risks for developing inflammatory diseases. The aim of our study was to examine how serum liver transaminases, as inexpensive and routinely measured markers, and the De Ritis ratio are associated with the presence of coronary artery ectasia (CAE) and its severity. METHODS Participants were recruited from patients admitted to Tehran Heart Center for diagnostic coronary angiography due to suspected myocardial ischaemia. These participants also underwent concurrent laboratory routine biochemical and liver enzyme tests. RESULTS A total of 104 participants were included; 59 had CAE and 45 were controls without coronary artery disease (CAD). The CAE group was split into a further two subgroups: those with isolated CAE (n=27) and those with CAD and coexisting CAE (n=32). In the adjusted multivariate analysis, a lower ratio of aspartate aminotransferase to ALT (AST/ALT) was, uniquely among the variables, a statistically significant marker for isolated CAE. In the CAD + CAE group, the AST/ALT ratio was not significant after adjustments for the confounding factors. The multivariate linear regression for the Markis score showed that the AST/ALT ratio was inversely associated with the severity of CAE. CONCLUSIONS We conclude that the AST/ALT ratio and, to some extent, ALT independently of other inflammatory factors, can be associated with the presence and severity of isolated CAE.
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Affiliation(s)
- Danesh Soltani
- Students’ Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Samira Jafari
- Students’ Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Haleh Ashraf
- Cardiac Primary Prevention Research Center (CPPRC), Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Cardiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Sobh-Rakhshankhah
- Cardiac Primary Prevention Research Center (CPPRC), Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Kolahchi
- Students’ Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Farzad Masoudkabir
- Cardiac Primary Prevention Research Center (CPPRC), Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Boroumand
- Department of Pathology and Laboratory Medicine, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Vasheghani-Farahani
- Cardiac Primary Prevention Research Center (CPPRC), Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
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13
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Dereli S, Çerik İB, Kaya A, Bektaş O. Assessment of the Relationship Between C-Reactive Protein-to-Albumin Ratio and the Presence and Severity of Isolated Coronary Artery Ectasia. Angiology 2020; 71:840-846. [PMID: 32519552 DOI: 10.1177/0003319720930983] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We investigated the relationship between C-reactive protein-to-albumin ratio (CAR) and coronary artery ectasia (CAE). The retrospective study population included 150 patients with isolated CAE, 150 with obstructive coronary artery disease (CAD), and 150 with a normal coronary artery angiogram (NCA). The severity of isolated CAE was determined according to the Markis classification. C-reactive protein-to-albumin ratio was significantly higher in patients with isolated CAE than in those with obstructive CAD and NCA (10.5 [5.9-30.9], 5.7 [1.8-13.2] and 3.0 [0.9-8.9], respectively). Logistic regression analysis showed that CAR (odds ratio [OR]: 3.054, 95% CI: 1.021-9.165, P = .001), platelet-to-lymphocyte ratio (PLR; OR: 1.330, 95% CI: 1.025-1.694, P = .044), and monocyte-to-high density cholesterol ratio (MHR; OR: 1.031, 95% CI: 1.009-1.054, P = .006) were independently associated with the presence of isolated CAE. Receiver operating characteristic curve analysis showed that CAR (area under the curve [AUC] ± standard error [SE] = 0.838 ± 0.016; P < .001) had a stronger diagnostic value for detecting significant CAE than PLR (AUC ± SE = 0.632 ± 0.023) and MHR (AUC ± SE = 0.726 ± 0.022). C-reactive protein-to-albumin ratio had a significantly strong correlation with the severity of isolated CAE (r = 0.536, P < .001). To the best of our knowledge, this study showed for the first time that CAR was significantly associated with CAE presence and severity.
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Affiliation(s)
- Seçkin Dereli
- Department of Cardiology, 472606Ordu University Faculty of Medicine, Turkey
| | - İdris Buğra Çerik
- Department of Cardiology, 472606Ordu University Faculty of Medicine, Turkey
| | - Ahmet Kaya
- Department of Cardiology, 472606Ordu University Faculty of Medicine, Turkey
| | - Osman Bektaş
- Department of Cardiology, 472606Ordu University Faculty of Medicine, Turkey
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Yavcin O, Askin L, Seçen O, Turkmen S, Akturk E, Tanriverdi O, Necati Dagli M. Copeptin levels in patients with coronary artery ectasia. Interv Med Appl Sci 2020; 11:112-116. [PMID: 32148915 PMCID: PMC7044535 DOI: 10.1556/1646.11.2019.08] [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] [Indexed: 11/19/2022] Open
Abstract
Background and aims The etiology and pathophysiology of coronary artery ectasia (CAE) has not been fully elucidated. A rapid rise in plasma copeptin has been observed in cardiovascular diseases, stroke, sepsis, and shock. This increase has diagnostic and prognostic value. The aim of this study was to investigate whether copeptin has a relationship with CAE. Methods This observational prospective study was carried out between October 2012 and March 2013 in the cardiology catheter laboratory with the inclusion of 44 subjects with a diagnosis of CAE and 44 age- and gender-matched individuals with normal coronary arteries. Blood samples obtained from the patients were stored at -70 °C until analysis and copeptin levels in sera were measured by ELISA. Results This study comprised 88 study participants, among whom 44 were patients meeting ectasia criteria [mean age: 58.0 ± 11.5 years; 59% (n = 26) male], and 44 were control subjects with angiographically normal coronary anatomy [mean age: 49.2 ± 10.1 years; 30% (n = 13) male]. Copeptin levels were similar between the groups (p > 0.05). In addition, there was no correlation between copeptin levels and CAE. Conclusion In this study, it is examined that copeptin levels were not elevated in CAE patients.
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Affiliation(s)
- Ozkan Yavcin
- Department of Cardiology, Adiyaman Education and Research Hospital, Adiyaman, Turkey
| | - Lutfu Askin
- Department of Cardiology, Adiyaman Education and Research Hospital, Adiyaman, Turkey
| | - Ozlem Seçen
- Department of Cardiology, Elazig Education and Research Hospital, Elazig, Turkey
| | - Serdar Turkmen
- Department of Cardiology, Adiyaman Education and Research Hospital, Adiyaman, Turkey
| | - Erdal Akturk
- Department of Cardiology, Adiyaman Education and Research Hospital, Adiyaman, Turkey
| | - Okan Tanriverdi
- Department of Cardiology, Adiyaman Education and Research Hospital, Adiyaman, Turkey
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15
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Kurtul A, Ornek E. Platelet to Lymphocyte Ratio in Cardiovascular Diseases: A Systematic Review. Angiology 2019; 70:802-818. [PMID: 31030530 DOI: 10.1177/0003319719845186] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The platelet to lymphocyte ratio (PLR) is an integrated reflection of 2 opposite thrombotic/inflammatory pathways that are easily calculated from a complete blood count. The PLR initially served as a systemic inflammatory biomarker to predict the prognosis of neoplastic diseases. In recent years, the PLR has been used as a prognostic marker in cardiovascular (CV) conditions. In this review, we consider the evidence regarding the association of the PLR with CV disease (CVD) and its possible use as a prognostic marker of CVD. The role of PLR has been investigated in CV conditions in several studies. We assessed clinical trials using PubMed, EMBASE, and Web of Science (up to April 18, 2018) to evaluate the association between PLR and mortality/major adverse cardiac events in these conditions. Most of these studies reported significant relationships between a high PLR and diverse outcomes. In conclusion, we suggest that PLR is a cheap and easily available systemic inflammatory marker that can predict distinct outcomes in different types of CVD.
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Affiliation(s)
- Alparslan Kurtul
- 1 Cardiology Department, Tayfur Ata Sokmen Faculty of Medicine, Hatay Mustafa Kemal University, Hatay, Antakya, Turkey
| | - Ender Ornek
- 2 Cardiology Department, Ankara Numune Education and Research Hospital, Health Sciences University, Ankara, Turkey
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16
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Primary percutaneous coronary intervention in ST-elevation myocardial infarction with an ectatic infarct-related artery. Coron Artery Dis 2019; 30:277-284. [PMID: 30789360 DOI: 10.1097/mca.0000000000000720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study was to describe the procedural characteristics, myocardial perfusion, and long-term outcomes in ST-elevation myocardial infarction patients with an ectatic infarct-related artery (IRA). PATIENTS AND METHODS The retrospective analysis included 1270 consecutive ST-elevation myocardial infarction patients treated by primary percutaneous coronary intervention who were categorized according to the coronary anatomy of the IRA as follows: ectatic group (n=91) and control group (n=1179). RESULTS Compared with the control group, patients in the ectatic group experienced lower Thombolysis in myocardial infarction grade 3 flow rate after percutaneous coronary intervention (64.8 vs. 88.2%: ectatic group vs. nonectatic group, P<0.001) and more frequent distal embolization (44.4 vs. 11.1%, P<0.001). ECG ST resolution was significantly lower in the ectatic group (P<0.001). Paradoxically, the left ventricular ejection fraction values at discharge were significantly higher in the ectatic group (P=0.032) and the infarct size assessed within 6-12 months after discharge tended to be smaller (P=0.06). The 30-day mortality rate was not significantly different between the two groups (3.3 vs. 5.0%, P=0.378) as well as Kaplan-Meier analysis for long-term overall survival in both groups (P=0.8). CONCLUSION Patients with ectatic IRA were characterized by discrepancies between high angiographic thrombus burden in a larger vessel and impact on left ventricular function that may influence their long-term survival.
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17
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Uygun T, Demir B, Tosun V, Ungan İ, Kural A, Çiftçi R, Fatullayev F. Relationship between interleukin-17A and isolated coronary ectasia. Cytokine 2018; 115:84-88. [PMID: 30470660 DOI: 10.1016/j.cyto.2018.11.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 09/04/2018] [Accepted: 11/13/2018] [Indexed: 01/22/2023]
Abstract
The aim of this study was to evaluate serum interleukin (IL)-17A levels in patients with coronary artery ectasia (CAE), the relationship between IL and 17A and CAE, and to determine the relationship between the severity of coronary ectasia and the level of IL-17A. In total, 41 patients (19 female and 22 male) with ischemic symptoms whose non-invasive cardiac tests were positive for myocardial ischemia, and in whom coronary artery ectasia were detected after coronary angiography, and 45 patients (32 female and 13 male) with normal coronary arteries were included in this study. Echocardiographic assessments were performed. Serum IL-17A levels of all patients were evaluated using an enzyme-linked immunosorbent assay. IL-17A levels of the group with isolated coronary artery ectasia were significantly higher compared with the control group (4.86 ± 3.24 and 1.37 ± 1.56 ng/ml, respectively; p < 0.001). There was no correlation between the levels of IL-17A and the extension of the CAE, but IL-17A levels were high in both groups. CAE patients have significantly increased levels of IL-17A, fibrinogen, and RDW compared to patients with normal coronary arteries. It was demonstrated that increased levels of IL-17A were associated with ectasia formation in CAE patients.
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Affiliation(s)
- Turgut Uygun
- Department of Cardiology, Şanlıurfa Training and Research Hospital, Şanlıurfa, Turkey
| | - Bülent Demir
- Department of Cardiology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Veysel Tosun
- Department of Cardiology, Şanlıurfa Training and Research Hospital, Şanlıurfa, Turkey.
| | - İsmail Ungan
- Department of Cardiology, Yalova State Hospital, Yalova, Turkey
| | - Alev Kural
- Department of Cardiology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Rumeysa Çiftçi
- Department of Cardiology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Fuad Fatullayev
- Department of Cardiology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
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18
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Choi HJS, Luong C, Fung A, Tsang TSM. ST-Elevation Myocardial Infarction in Coronary Ectasia: A Case Report. Diseases 2018; 6:diseases6040104. [PMID: 30453473 PMCID: PMC6313525 DOI: 10.3390/diseases6040104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 10/30/2018] [Accepted: 11/15/2018] [Indexed: 11/16/2022] Open
Abstract
Coronary artery ectasia (CAE) is localized or diffuse dilatation of the coronary artery lumen exceeding the diameter of adjacent healthy reference segments by 1.5 times. It is a rare phenomenon and incidence ranges from 1 to 5% in patients undergoing angiography. We report a case of a 58-year-old man with atherosclerotic CAE who experienced ST-elevation myocardial infarction (STEMI) despite prophylactic antiplatelet therapy. He was successfully treated with IV eptifibatide and aspiration thrombectomy. We reviewed the literature of CAE presentation, etiology and treatment and discussed the most appropriate antithrombotic therapy to prevent STEMIs in patients with CAE. While the current literature appears to favour prophylactic antiplatelet and anticoagulant in these patients, more studies are needed to determine the optimal form and duration of antithrombotic therapy. Currently, there is no gold standard treatment for CAE and further prospective and randomized-controlled studies are needed to guide recommendations.
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Affiliation(s)
- Hye Ji Sally Choi
- Division of Cardiology and Cardiovascular Surgery, Vancouver General Hospital, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
| | - Christina Luong
- Division of Cardiology and Cardiovascular Surgery, Vancouver General Hospital, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
| | - Anthony Fung
- Division of Cardiology and Cardiovascular Surgery, Vancouver General Hospital, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
| | - Teresa S M Tsang
- Division of Cardiology and Cardiovascular Surgery, Vancouver General Hospital, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
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Gunasekaran P, Stanojevic D, Drees T, Fritzlen J, Haghnegahdar M, McCullough M, Barua R, Mehta A, Hockstad E, Wiley M, Earnest M, Tadros P, Genton R, Gupta K. 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. Catheter Cardiovasc Interv 2018; 93:1219-1227. [DOI: 10.1002/ccd.27929] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Accepted: 09/23/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Prasad Gunasekaran
- Division of Cardiovascular Diseases; University of Kansas Medical Center; Kansas City Kansas
| | - Dusan Stanojevic
- Division of Cardiovascular Diseases; University of Kansas Medical Center; Kansas City Kansas
| | - Taylor Drees
- Division of Cardiovascular Diseases; University of Kansas Medical Center; Kansas City Kansas
| | - John Fritzlen
- Division of Cardiovascular Diseases; University of Kansas Medical Center; Kansas City Kansas
| | - Megan Haghnegahdar
- Division of Cardiovascular Diseases; University of Kansas Medical Center; Kansas City Kansas
| | - Matthew McCullough
- Division of Cardiovascular Diseases; University of Kansas Medical Center; Kansas City Kansas
| | - Rajat Barua
- Division of Cardiology; Kansas City Veterans Affairs Medical Center; Kansas City Missouri
| | - Ashwani Mehta
- Division of Cardiovascular Diseases; University of Kansas Medical Center; Kansas City Kansas
| | - Eric Hockstad
- Division of Cardiovascular Diseases; University of Kansas Medical Center; Kansas City Kansas
| | - Mark Wiley
- Division of Cardiovascular Diseases; University of Kansas Medical Center; Kansas City Kansas
| | - Matthew Earnest
- Division of Cardiovascular Diseases; University of Kansas Medical Center; Kansas City Kansas
| | - Peter Tadros
- Division of Cardiovascular Diseases; University of Kansas Medical Center; Kansas City Kansas
| | - Randall Genton
- Division of Cardiovascular Diseases; University of Kansas Medical Center; Kansas City Kansas
| | - Kamal Gupta
- Division of Cardiovascular Diseases; University of Kansas Medical Center; Kansas City Kansas
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20
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Korovesis T, Katritsis G, Koudounis P, Zografos T. Coronary artery ectasia in Crohn's disease. BMJ Case Rep 2018; 2018:bcr-2018-226813. [PMID: 30344153 DOI: 10.1136/bcr-2018-226813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Coronary artery ectasia (CAE) can be ascribed, in the majority of cases, to coronary atherosclerosis. Nevertheless, the presence of isolated ectatic lesions without obstructive coronary artery disease and the association of CAE with several autoimmune diseases characterised by systemic vascular involvement suggest that the pathogenesis of CAE may extend beyond coronary atherosclerosis. We herein report the case of a 56-year-old male patient with Crohn's disease and isolated CAE, who has been found positive for IgM and IgA antiendothelial cell antibodies, and discuss a potential pathogenic mechanism.
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21
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Inflammation in Coronary Artery Ectasia Compared to Atherosclerosis. Int J Mol Sci 2018; 19:ijms19102971. [PMID: 30274244 PMCID: PMC6213113 DOI: 10.3390/ijms19102971] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Accepted: 09/28/2018] [Indexed: 02/04/2023] Open
Abstract
We have read with great enthusiasm the article recently published by Boles et al. [...].
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22
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Dilating Vascular Diseases: Pathophysiology and Clinical Aspects. Int J Vasc Med 2018; 2018:9024278. [PMID: 30225143 PMCID: PMC6129317 DOI: 10.1155/2018/9024278] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Accepted: 07/29/2018] [Indexed: 01/22/2023] Open
Abstract
Atherosclerotic disease of the vessels is a significant problem affecting mortality and morbidity all over the world. However, dilatation of the vessels either in the arterial system or in the venous territory is another vessel disease. Varicocele, pelvic, and peripheral varicose veins and hemorrhoids are aneurysms of the venous vascular regions and have been defined as dilating venous disease, recently. Coronary artery ectasia, intracranial aneurysm, and abdominal aortic aneurysm are examples of arterial dilating vascular diseases. Mostly, they have been defined as variants of atherosclerosis. Although there are some similarities in terms of pathogenesis, they are distinct from atherosclerotic disease of the vessels. In addition, pathophysiological and histological similarities and clinical coexistence of these diseases have been demonstrated both in the arterial and in the venous system. This situation underlies the thought that dilatation of the vessels in any vascular territory should be considered as a systemic vessel wall disease rather than being a local disease of any vessel. These patients should be evaluated for other dilating vascular diseases in a systematic manner.
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23
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Ashraf H, Soltani D, Sobh-Rakhshankhah A, Jafari S, Boroumand MA, Goudarzi V, Vasheghani Farahani A, Masoudkabir F. Visfatin as marker of isolated coronary artery ectasia and its severity. Cytokine 2018; 113:216-220. [PMID: 30001864 DOI: 10.1016/j.cyto.2018.07.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 06/13/2018] [Accepted: 07/04/2018] [Indexed: 11/24/2022]
Abstract
Several studies have demonstrated the relationship between visfatin and increased risk of diseases caused by inflammation, however, the relationship between visfatin and coronary artery ectasia (CAE) is still unknown. The aim of our study is to investigate the association between serum visfatin with presence of coronary ectasia and its severity. We enrolled 85 individuals including 35 CAE patients (mean age: 58.40 ± 9.82 years) and 50 control persons (mean age: 53.24 ± 8.81 years). These participants underwent some biochemical tests including visfatin, fasting blood glucose and lipid profiles. In univariate analysis, the serum level of visfatin was significantly associated with ectasia in all patients with CAE and CAD coexisting with CAE groups, but a trend toward significance in isolated CAE group. In multivariate analysis, visfatin showed independently significant association with presence of ectasia in all patients with ectasia and in CAD coexisting with ectasia groups, but not significant in isolated CAE group. Visfatin was also independently associated with severity of ectasia according to MARKIS classification. We conclude that visfatin independently can be the useful predictor for the presence and severity of coronary ectasia.
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Affiliation(s)
- Haleh Ashraf
- Cardiac Primary Prevention Research Center (CPPRC), Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Danesh Soltani
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Sobh-Rakhshankhah
- Cardiac Primary Prevention Research Center (CPPRC), Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Samira Jafari
- Cardiac Primary Prevention Research Center (CPPRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Boroumand
- Department of Pathology and Laboratory Medicine, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Vina Goudarzi
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Vasheghani Farahani
- Cardiac Primary Prevention Research Center (CPPRC), Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Farzad Masoudkabir
- Cardiac Primary Prevention Research Center (CPPRC), Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
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24
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Ozturk S, Yetkin E, Waltenberger J. Molecular and cellular insights into the pathogenesis of coronary artery ectasia. Cardiovasc Pathol 2018; 35:37-47. [PMID: 29772448 DOI: 10.1016/j.carpath.2018.04.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 03/17/2018] [Accepted: 04/12/2018] [Indexed: 01/17/2023] Open
Abstract
Coronary artery ectasia describes a local or diffuse dilatation of the epicardial coronary arteries. This review summarizes the molecular and cellular mechanisms involved in the pathogenesis of coronary artery ectasia. Better identification of the pathophysiologic steps will shed light into the clinical significance and may have direct implications for the management strategies of this disease. Additionally, understanding the underlying etiology may help to improve treatment modalities specific to coronary artery ectasia.
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Affiliation(s)
- Selcuk Ozturk
- Ankara Education and Research Hospital, Department of Cardiology, Ankara 06230, Turkey.
| | - Ertan Yetkin
- Private Yenisehir Hospital, Department of Cardiology, Mersin, Turkey
| | - Johannes Waltenberger
- University of Münster, Faculty of Medicine, Münster, Germany; Cells-in-Motion Cluster of Excellence (EXC 1003-CiM), University of Münster, Münster, Germany
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Boles U, Johansson A, Wiklund U, Sharif Z, David S, McGrory S, Henein MY. Cytokine Disturbances in Coronary Artery Ectasia Do Not Support Atherosclerosis Pathogenesis. Int J Mol Sci 2018; 19:E260. [PMID: 29337902 PMCID: PMC5796206 DOI: 10.3390/ijms19010260] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 01/10/2018] [Accepted: 01/15/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Coronary artery ectasia (CAE) is a rare disorder commonly associated with additional features of atherosclerosis. In the present study, we aimed to examine the systemic immune-inflammatory response that might associate CAE. METHODS Plasma samples were obtained from 16 patients with coronary artery ectasia (mean age 64.9 ± 7.3 years, 6 female), 69 patients with coronary artery disease (CAD) and angiographic evidence for atherosclerosis (age 64.5 ± 8.7 years, 41 female), and 140 controls (mean age 58.6 ± 4.1 years, 40 female) with normal coronary arteries. Samples were analyzed at Umeå University Biochemistry Laboratory, Sweden, using the V-PLEX Pro-Inflammatory Panel 1 (human) Kit. Statistically significant differences (p < 0.05) between patient groups and controls were determined using Mann-Whitney U-tests. RESULTS The CAE patients had significantly higher plasma levels of INF-γ, TNF-α, IL-1β, and IL-8 (p = 0.007, 0.01, 0.001, and 0.002, respectively), and lower levels of IL-2 and IL-4 (p < 0.001 for both) compared to CAD patients and controls. The plasma levels of IL-10, IL-12p, and IL-13 were not different between the three groups. None of these markers could differentiate between patients with pure (n = 6) and mixed with minimal atherosclerosis (n = 10) CAE. CONCLUSIONS These results indicate an enhanced systemic pro-inflammatory response in CAE. The profile of this response indicates activation of macrophages through a pathway and trigger different from those of atherosclerosis immune inflammatory response.
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Affiliation(s)
- Usama Boles
- Department of Public Health and Clinical Medicine, Umeå University, 901 87 Umeå, Sweden.
- Cardiology Department, Letterkenny University Hospital, Letterkenny, F92 AE81, Co. Donegal, Ireland.
| | - Anders Johansson
- Department of Public Health and Clinical Medicine, Umeå University, 901 87 Umeå, Sweden.
- Molecular Periodontology and Odontology, Umeå University, 901 87 Umeå, Sweden.
| | - Urban Wiklund
- Department of Radiation Sciences, Umeå University, 901 87 Umeå, Sweden.
| | - Zain Sharif
- Cardiology Department, Letterkenny University Hospital, Letterkenny, F92 AE81, Co. Donegal, Ireland.
| | - Santhosh David
- Cardiology Department, Letterkenny University Hospital, Letterkenny, F92 AE81, Co. Donegal, Ireland.
| | - Siobhan McGrory
- Cardiology Department, Letterkenny University Hospital, Letterkenny, F92 AE81, Co. Donegal, Ireland.
| | - Michael Y Henein
- Department of Public Health and Clinical Medicine, Umeå University, 901 87 Umeå, Sweden.
- Molecular & Clinical Sciences Research Institute, St. George University, London SW17 0RE, UK.
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Affiliation(s)
- Selcuk Ozturk
- 1 Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey
| | - Ertan Yetkın
- 2 Department of Cardiology, Private Yenisehir Hospital, Mersin, Turkey
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Luo Y, Tang J, Liu X, Qiu J, Ye Z, Lai Y, Yao Y, Li J, Wang X, Liu X. Coronary Artery Aneurysm Differs From Coronary Artery Ectasia: Angiographic Characteristics and Cardiovascular Risk Factor Analysis in Patients Referred for Coronary Angiography. Angiology 2017; 68:823-830. [PMID: 27568385 DOI: 10.1177/0003319716665690] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The differences in angiographic characteristics and cardiovascular (CV) risk factors between coronary artery aneurysm (CAA) and coronary artery ectasia (CAE) have not been compared systematically. Of 10 876 patients undergoing coronary angiography, patients with CAA (n = 85) and CAE (n = 51) were screened. The prevalence of CAA was greater than that of CAE ( P < .05). The right coronary artery was the most involved (70.6%) in CAE compared with left circumflex (52.9%) and left anterior descending (41.2%). Coronary artery aneurysm coexisted with coronary artery disease (CAD) more frequently than CAE ( P = .002), and the modified Gensini score of CAA was also higher than that of CAE ( P < .001). The average maximum diameter was smaller, and corrected Thrombolysis in Myocardial Infarction (TIMI) frame count was lower in CAA than CAE in all 3 coronary arteries ( P < .001). Multivariate analysis showed that hyperlipidemia ( P = .02), smoking ( P = .04), and family history of CAD ( P = .02) were the independent variables most strongly associated with CAA, but not CAE. This study suggests that there are significant differences in coronary angiographic characteristics and CV risk factors between CAA and CAE.
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Affiliation(s)
- Yu Luo
- 1 Department of Cardiovascular, Tongji University School of Medicine, Shanghai East Hospital, Shanghai, China
| | - Jiani Tang
- 1 Department of Cardiovascular, Tongji University School of Medicine, Shanghai East Hospital, Shanghai, China
| | - Xu Liu
- 2 State Key Laboratory of Genetic Engineering and Ministry of Education Key Laboratory of Contemporary Anthropology, School of Life Sciences, Fudan University, Shanghai, China
| | - Jianping Qiu
- 3 Department of Cardiovascular, Gongli Hospital of Shanghai Pudong New District, Shanghai, China
| | - Zi Ye
- 1 Department of Cardiovascular, Tongji University School of Medicine, Shanghai East Hospital, Shanghai, China
| | - Yan Lai
- 1 Department of Cardiovascular, Tongji University School of Medicine, Shanghai East Hospital, Shanghai, China
| | - Yian Yao
- 1 Department of Cardiovascular, Tongji University School of Medicine, Shanghai East Hospital, Shanghai, China
| | - Jimin Li
- 1 Department of Cardiovascular, Tongji University School of Medicine, Shanghai East Hospital, Shanghai, China
| | - Xiaodong Wang
- 1 Department of Cardiovascular, Tongji University School of Medicine, Shanghai East Hospital, Shanghai, China
| | - Xuebo Liu
- 1 Department of Cardiovascular, Tongji University School of Medicine, Shanghai East Hospital, Shanghai, China
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Ovalı C, Morrad B. Associations between coronary artery disease, aneurysm and ectasia. KARDIOCHIRURGIA I TORAKOCHIRURGIA POLSKA = POLISH JOURNAL OF CARDIO-THORACIC SURGERY 2017; 14:158-163. [PMID: 29181042 PMCID: PMC5701588 DOI: 10.5114/kitp.2017.70276] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 08/02/2017] [Indexed: 02/06/2023]
Abstract
AIM Investigation the frequency and contribution of coronary artery aneurysm/ectasia in addition to their correlation with coronary artery disease (CAD). MATERIAL AND METHODS We retrospectively evaluated the coronary angiography records of 6500 adult consecutive patients, and 418 of them were met inclusion criteria and used in the present study. The CAD was defined as the presence of angiographic coronary stenosis of > 50% of the luminal diameter in no less than one of the epicardial coronary arteries. Moreover, the prevalence and features of the coronary artery aneurysm/ectasia among the cases with and without CAD were compared. RESULTS We observed coronary artery aneurysm (CAA) and ectasia (CAE) in 6.6% of the patients with significant CAD (+), and 6.1% of the patients with significant CAD (-) (p = 0.2). The percentage of coronary artery aneurysms was significantly higher in CAD (+) patients than in CAD (-) patients (0.8% vs. 0.4%, p = 0.015). The percentage of coronary artery ectasia showed no variation between CAD (+) patients and CAD (-) patients (5.8% vs. 5.7%, p = 0.47). The frequency of spotting aneurysm on a single coronary artery was higher than discerning aneurysm on two or three coronary arteries. CONCLUSIONS Presence of CAA or CAE cases is often encountered in those who have undergone angiography procedures. Furthermore, CAA and CAE should not be considered as simple dilations of vessels. Further studies are needed to determine the effective procedures for the treatment and prognostic evaluations of the patients with CAA or CAE.
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Affiliation(s)
- Cengiz Ovalı
- Cardiovascular Surgery Department, Medical Faculty, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Baktash Morrad
- Department of Cardiology, Parkhayat Akşehir Hospital, Afyonkarahisar, Turkey
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Fang CT, Fang YP, Huang YB, Kuo CC, Chen CY. Epidemiology and risk factors of coronary artery aneurysm in Taiwan: a population based case control study. BMJ Open 2017; 7:e014424. [PMID: 28667203 PMCID: PMC5734584 DOI: 10.1136/bmjopen-2016-014424] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES Coronary artery aneurysm (CAA) is usually an asymptomatic and rare disease. There are limited epidemiological data for CAA in Asian populations and in the rest of the world. DESIGN A retrospective case control study. SETTING A population based, database study from Taiwan's National Health Insurance Research Database, between 2005 and 2011. PARTICIPANTS CAA patients identified using International Classification of Diseases, ninth revision, clinical modification (ICD-9-CM) code 414.11 with CAA examinations. OUTCOME MEASURES The incidence rate and mortality rate of CAA were calculated. We also matched patients with non-CAA patients according to age, gender and index year at a 1:10 ratio to explore the risk factors for CAA using conditional logistic regression. RESULT A total of 1397 CAA patients were identified between 2005 and 2011; 41.9% were paediatric patients and 58.1% were adults. The incidence rate and mortality rate of CAA in Taiwan were 0.87 and 0.05 per 105 person-years, respectively. The adjusted odds ratios (aOR) for coronary atherosclerosis, hypertension, dyslipidaemia and diabetes were 7.97, 2.09, 2.48 and 1.51, respectively. Of note, aortic dissection (aOR 6.76), aortic aneurysm (aOR 5.82) and systemic lupus erythematosus (aOR 4.09) were found to be significantly associated with CAA. CONCLUSION In Taiwan, CAA patients were distributed across both paediatric and adult populations. Apart from cardiovascular risk factors, aortic diseases and systemic lupus erythematosus need to be investigated further in CAA patients.
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Affiliation(s)
- Chein-Tang Fang
- School of Pharmacy, Master Program in Clinical Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Ping Fang
- School of Pharmacy, Master Program in Clinical Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yaw-Bin Huang
- School of Pharmacy, Master Program in Clinical Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chen-Chun Kuo
- Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chung-Yu Chen
- School of Pharmacy, Master Program in Clinical Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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Ozturk S, Yetkin E. Increased inflammatory status in chronic venous insufficiency patients. Phlebology 2017; 32:641-642. [DOI: 10.1177/0268355517714354] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Selcuk Ozturk
- Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey
| | - Ertan Yetkin
- Department of Cardiology, Private Yenisehir Hospital, Mersin, Turkey
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Li Y, Wu C, Liu W. Coronary artery ectasia presenting with thrombus embolization and acute myocardial infarction: A case report. Medicine (Baltimore) 2017; 96:e5976. [PMID: 28121950 PMCID: PMC5287974 DOI: 10.1097/md.0000000000005976] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Coronary artery ectasia (CAE) is characterized by an abnormal dilatation of the coronary arteries. CAE is often associated with the presence of slow coronary flow and may lead to acute myocardial infarction (AMI), even without total occlusion. PATIENT CONCERNS AND DIAGNOSIS We report a case of a 24-year-old male patient with CAE suffering from AMI. INTERVENTIONS Percutaneous coronary intervention with aspiration thrombectomy failed to restore adequate blood flow. Heparin and antiplatelet treatment were provided for pharmacological management, but follow-up angiography 15 days later still revealed a poor result. This patient was ultimately treated with antiplatelet therapy in combination with warfarin treatment. OUTCOMES Follow-up coronary angiography 15 months later showed a restored normal Thrombolysis In Myocardial Infarction grade (TIMI) 3 flow. LESSONS CAE-related infarct is often associated with high-burden thrombus formation. Long-term warfarin in combination with antiplatelet therapy may be a good alternative intervention to decrease thrombus burden and enhance blood flow.
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Yetkin E, Ozturk S. Coronary Artery Aneurysm and Coronary Artery Ectasia: What Makes the Difference? Angiology 2016; 68:833. [PMID: 27784732 DOI: 10.1177/0003319716675795] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Ertan Yetkin
- 1 Department of Cardiology, Private Yenisehir Hospital, Mersin, Turkey
| | - Selcuk Ozturk
- 2 Department of Cardiology, Ankara Training and Research Hospital, Ankara, Turkey
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Thiol/disulfide homeostasis: A new insight into coronary artery ectasia. Atherosclerosis 2016; 253:273-274. [DOI: 10.1016/j.atherosclerosis.2016.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 08/18/2016] [Indexed: 11/23/2022]
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Yolcu M, Ipek E, Turkmen S, Ozen Y, Yildirim E, Sertcelik A, Ulusoy FR. The relationship between elevated magnesium levels and coronary artery ectasia. Cardiovasc J Afr 2016; 27:294-298. [PMID: 27123953 PMCID: PMC5370359 DOI: 10.5830/cvja-2016-023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Accepted: 03/08/2016] [Indexed: 02/05/2023] Open
Abstract
Backround Coronary artery ectasia (CAE) without specific symptoms is the localised or diffuse swelling of the epicardial coronary arteries. Magnessium (Mg) plays an important role in cardiac excitability, vascular tonus, contractibility, reactivity and vasodilatation. In our research, we aimed to study the vasodilatory effect of Mg in the aetiopathogenesis of ectasia. Methods Patients identified during routine coronary angiograms in our clinic between January 2010 and 2013 were included in the study. Sixty-two patients with isolated CAE, 57 with normal coronary angiograms (NCA), 73 with severe coronary artery disease (CAD), and 95 with stenosis of at least one coronary artery and CAE (CAD + CAE) were included in the study. Serum Mg levels were measured in mg/ dl after 12 hours of fasting. Results There were no statistically significant differences between the groups in terms of age, hypertension, smoking, hyperlipidaemia, diabetes mellitus, family history of coronary artery disease and medications used. Serum glucose, thyroid stimulating hormone (TSH), urea, total cholesterol, triglyceride, low-density lipoprotein (LDL) cholesterol, sodium and potassium levels were similar in all groups. Serum Mg levels were 1.90 ± 0.19 mg/dl in patients with isolated CAE, 1.75 ± 0.19 mg/dl in those with CAD, 1.83 ± 0.20 mg/dl in those with CAD + CAE, and 1.80 ± 0.16 mg/dl in the NCA group. These results show that Mg levels were higher in ectasia patients with or without CAD. Conclusions The histopathological characteristics of patients with CAE were similar to those with CAD. The specific mechanism of abnormal luminal dilatation seen in CAE however remains to be elucidated. Mg is a divalent cation with powerful vasodilatory effects. In our study, serum Mg levels were found to be statistically higher in ectasia patients with or without CAD.
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Affiliation(s)
- Mustafa Yolcu
- Department of Cardiology, Arel Universty, Private Medicana Camlica Hospital, Istanbul, Turkey.
| | - Emrah Ipek
- Department of Cardiology, Erzurum Region Training and Research Hospital, Erzurum, Turkey
| | - Serdar Turkmen
- Department of Cardiology, Sani Konukoğlu Medical Centre, Gaziantep, Turkey
| | - Yücel Ozen
- Department of Cardiovascular Surgery, Kartal Kosuyolu High Specialty Education and Research Hospital, Erzurum, Turkey
| | - Erkan Yildirim
- Department of Cardiology, Erzurum Region Training and Research Hospital, Erzurum, Turkey
| | - Alper Sertcelik
- Department of Cardiology, Sani Konukoğlu Medical Centre, Gaziantep, Turkey
| | - Fatih Rifat Ulusoy
- Department of Cardiology, Erzurum Region Training and Research Hospital, Erzurum, Turkey
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Yetkin E, Ileri M. Dilating venous disease: Pathophysiology and a systematic aspect to different vascular territories. Med Hypotheses 2016; 91:73-76. [PMID: 27142148 DOI: 10.1016/j.mehy.2016.04.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 04/06/2016] [Accepted: 04/09/2016] [Indexed: 12/13/2022]
Abstract
Venous disease is a common but overlooked clinical problem and is an important mortality and morbidity factor depending on the effected vascular territory. Different contributing factors play role on the clinical manifestation of the disease. Peripheral varices of lower extremities, hemorrhoids, varicoceles, pelvic varicose veins are the vasculopathy of veins running toward heart but against gravity. We hypothesize that all these clinical entities share common pathophysiologic steps in terms of vascular wall remodeling and vessel wall damage. A systematic approaches to both arterial and venous dilating disease in further studies and research would increase our understanding on the pathophysiology of dilating vascular disease and would provoke to find out new treatment modalities. Varicose remodeling of veins occurs by a complex interplay of various factors including both physical forces and extracellular matrix remodeling mechanisms. This article focuses on the systematic aspects of dilating venous disease with a focus on pathophysiology under the term of "Dilating Venous Disease".
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Affiliation(s)
- Ertan Yetkin
- Yenisehir Hospital, Division of Cardiology, Mersin, Turkey.
| | - Mehmet Ileri
- Numune Training and Research Hospital, Department of Cardiology, Ankara, Turkey
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Ozturk S, Yetkin E. Varicose Vein or Non-Varicose Vein: That is the Question. Eur J Vasc Endovasc Surg 2016; 51:883. [PMID: 27049865 DOI: 10.1016/j.ejvs.2016.02.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 02/19/2016] [Indexed: 11/26/2022]
Affiliation(s)
- S Ozturk
- Abant Izzet Baysal Research and Training Hospital, Department of Cardiology Bolu, Turkey
| | - E Yetkin
- Private Yenisehir Hospital Division of Cardiology Mersin, Turkey.
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Fariba F, Moradi M, Arabi A, Ghaderi B. Prevalence of Coronary Artery Ectasia with Atherosclerosis and Associated Risk Factors in the West of Iran: A Cross-Sectional Study. J Res Health Sci 2016; 16:22-5. [PMID: 27061992 PMCID: PMC7189084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2015] [Revised: 01/18/2016] [Accepted: 03/07/2016] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND According to the angiographic findings, 3%-8% of atherosclerotic coronary artery patients suffer from coronary artery ectasia (CAE). We conducted this study to estimate the prevalence of CAE among patients who underwent angiography and compared this group with those patients without CAE and atherosclerosis in terms of common coronary heart disease (CHD) risk factors. METHODS This cross sectional study was conducted in Hamadan Province, western Iran, from March 2014 to March 2015. Data were collected from angiography evaluation and clinical records in Ekbatan Hospital. The patients with atherosclerosis who had CAE were compared with patients who had neither CAE nor atherosclerosis. The categorical variables were compared using chi-squared test or Fisher's exact test. RESULTS Of 2767 patients who underwent coronary angiography, 166 (6.0%) had CAE with atherosclerosis, 2357 (85.2%) had atherosclerosis without CAE, and 244 (8.8%) had normal coronary artery. Compared to normal group, CAE patient were more hypertensive and smoker. Besides, in CAE group the proportion of dyslipidemia was higher than normal subject. CONCLUSIONS The prevalence of CAE in Hamadan Province was in the expected level. Distribution of common CHD risk factors were most prevalent in CAE patient in comparison with normal coronary artery group.
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Affiliation(s)
- Farnaz Fariba
- a Department of Cardiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mehdi Moradi
- a Department of Cardiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Arezzo Arabi
- b Clinical Research Development Unit of Farshchian Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
,Correspondence Arezzo Arabi (MSc) E-mail:
| | - Behzad Ghaderi
- a Department of Cardiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
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Turhan Caglar FN, Ksanski V, Polat V, Ungan I, Kural A, Ciftci S, Demir B, Ugurlucan M, Akturk F, Karakaya O. The Association Between α 1-Antitrypsin and Coronary Artery Ectasia. Angiology 2016; 67:927-931. [PMID: 26953238 DOI: 10.1177/0003319716635463] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Coronary artery ectasia (CAE) is associated with coronary artery disease (CAD). The underlying pathophysiology of CAE is not fully understood. α1-antitrypsin (A1AT) plays a role in the tissue protease system, and AAT-1 deficiency (A1ATD) has been shown to be related to CAD. We compared A1AT serum levels in patients with and without CAE to determine the association between A1AT levels and the extent of ectasia using the Markis score. We included 50 patients (38 males) with isolated CAE and 46 patients (28 males) with normal coronary arteries after coronary angiography. The levels of A1AT were measured by nephelometry. The median A1AT levels were lower in patients with isolated CAE than in the control group (1.27 ng/mL [range: 1.07-1.37 ng/mL] vs 1.43 ng/mL [range: 1.27-1.59 ng/mL]; P < .001). According to the Markis classification, the extent of CAE was not correlated with A1AT levels ( P = .41). Our results demonstrate an inverse relationship between serum A1AT levels and CAE. α1-antitrypsin is fundamental for the stability and integrity of the arterial wall. Lack of elastase inhibition in cases of A1ATD may contribute to ectasia formation by facilitating proteolysis and weakening the arterial wall.
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Affiliation(s)
| | - Vusal Ksanski
- 1 Cardiology Department, Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey
| | - Veli Polat
- 1 Cardiology Department, Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey
| | - Ismail Ungan
- 1 Cardiology Department, Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey
| | - Alev Kural
- 2 Biochemistry Department, Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey
| | - Serkan Ciftci
- 1 Cardiology Department, Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey
| | - Bulent Demir
- 1 Cardiology Department, Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey
| | - Murat Ugurlucan
- 3 Department of Cardiovascular Surgery, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
| | - Faruk Akturk
- 1 Cardiology Department, Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey
| | - Osman Karakaya
- 1 Cardiology Department, Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey
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Dahhan A. Coronary artery ectasia in atherosclerotic coronary artery disease, inflammatory disorders, and sickle cell disease. Cardiovasc Ther 2015; 33:79-88. [PMID: 25677643 DOI: 10.1111/1755-5922.12106] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Coronary artery ectasia (CAE) or aneurysm is usually defined as dilation ≥1.5-fold the normal vessel diameter. It has an incidence of 1.4-5.3% and is associated with a wide variety of etiologies-mainly congenital, atherosclerotic, and inflammatory ones. CAE is very common in sickle cell disease, and possibly sickle cell trait, with an incidence of 17.7%. It is likely related to the inflammatory process associated with hemoglobin S. Prognosis depends mainly on the underlying etiology. Atherosclerotic CAE does not carry additional risks compared to atherosclerotic coronary artery disease (ACAD) without ectasia. However, isolated CAE in the absence of ACAD carries an increased risk of myocardial infarction (MI) due to vasospasm, slower coronary blood flow, and thrombosis, typically within the dilated segments. Due to lack of studies and guidelines, management recommendations are based on personal experiences. Therapy should be tailored to each individual case after assessment of severity, history of complications, underlying etiology, and comorbidities. Treatment of underlying condition and avoidance of exacerbating factors are essential. Medical therapy in general may include antiplatelets, β-blockers, angiotensin-converting enzyme inhibitors statins, and dihydropyridine calcium channel blockers. In severe CAE or history of MI, the addition of anticoagulation therapy after assessing bleeding risk may be warranted. In acute MI, the large thrombus burden in the dilated segment makes the percutaneous approach very challenging. Aspiration attempts can result in distal thromboembolization. Survival is better in bypass grafting than with medical therapy. Nonetheless, bypass grafting does not improve survival in atherosclerotic CAE. Depending on the physical characteristics of aneurysm, different surgical approaches can be sought; however, the ideal one is unclear.
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Affiliation(s)
- Ali Dahhan
- Department of Internal Medicine, University of Iowa, Carver College of Medicine, Iowa City, IA, USA
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Roh JW, Park EH, Song JC, Oh YS, Kim TY, Kim HS, Lim S. ST-Segment Elevation Myocardial Infarction as a Result of Coronary Artery Ectasia-Related Intracoronary Thrombus in a Patient with Liver Cirrhosis. Korean J Crit Care Med 2015. [DOI: 10.4266/kjccm.2015.30.4.358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Ozturk S, Yalvac HD, Sivri N, Ozturk HM, Kılıc Y, Bulut E, Celik A, Barlas Y, Tengiz I, Yetkin E. Anxiety and depression scores in patients with coronary artery disease and coronary artery ectasia. Int J Cardiol 2015; 186:299-301. [PMID: 25828141 DOI: 10.1016/j.ijcard.2015.03.305] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 03/19/2015] [Indexed: 12/30/2022]
Affiliation(s)
- S Ozturk
- Abant Izzet Baysal University Izzet Baysal Research and Training Hospital, Department of Cardiology, Bolu, Turkey
| | - H D Yalvac
- DR Abdurrahman Yurtaslan Oncology Research and Training Hospital, Department of Psychiatry, Ankara, Turkey
| | - N Sivri
- Trakya University Faculty of Medicine, Department of Cardiology, Edirne Turkey
| | - H M Ozturk
- Abant Izzet Baysal University Izzet Baysal Research and Training Hospital, Department of Psychiatry, Bolu, Turkey
| | - Y Kılıc
- Abant Izzet Baysal University Izzet Baysal Research and Training Hospital, Department of Cardiology, Bolu, Turkey
| | - E Bulut
- Abant Izzet Baysal University Izzet Baysal Research and Training Hospital, Department of Cardiology, Bolu, Turkey
| | - A Celik
- Abant Izzet Baysal University Izzet Baysal Research and Training Hospital, Department of Cardiology, Bolu, Turkey
| | - Y Barlas
- Abant Izzet Baysal University Izzet Baysal Research and Training Hospital, Department of Cardiology, Bolu, Turkey
| | - I Tengiz
- Izmir University Medical Park Hospital, Department of Cardiology, Izmir, Turkey
| | - E Yetkin
- Middle East Hospital, Department of Cardiology, Mersin, Turkey.
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Kuno T, Numasawa Y, Sugiyama K, Yamazaki H, Motoda H, Kamei S, Takahashi T. A rare case of acute myocardial infarction with multivessel coronary artery ectasia successfully treated with percutaneous coronary intervention and systemic thrombolysis. Intern Med 2015; 54:1057-62. [PMID: 25948347 DOI: 10.2169/internalmedicine.54.2908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Coronary artery ectasia (CAE) is defined as a coronary artery dilatation with a diameter ≥1.5 times greater than that of a normal adjacent artery. All 3 coronary vessels can be affected by CAE, but the incidence of multivessel CAE among patients undergoing coronary angiography is quite low. We herein report an extremely rare case of acute myocardial infarction due to massive thrombi in the giant right coronary artery with multivessel CAE. Thrombus aspiration during percutaneous coronary intervention may be limited in giant coronary artery cases, and systemic thrombolysis may be effective in patients with massive thrombi in the giant coronary artery.
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Affiliation(s)
- Toshiki Kuno
- Department of Cardiology, Ashikaga Red Cross Hospital, Japan
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Yetkin E. Hemorrhoid, internal iliac vein reflux and peripheral varicose vein: Affecting each other or affected vessels? Phlebology 2014; 30:145. [PMID: 25527517 DOI: 10.1177/0268355514565196] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- E Yetkin
- Middle East Hospital Division of Cardiology, Mersin, Turkey
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Balderston JR, Giri J, Kolansky DM, Bavaria JE, Gertz ZM. Coronary artery aneurysms associated with ascending aortic aneurysms and abdominal aortic aneurysms: Pathophysiologic implications. Catheter Cardiovasc Interv 2014; 85:961-7. [DOI: 10.1002/ccd.25726] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 11/03/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Jessica R. Balderston
- Division of Cardiology; Virginia Commonwealth University Medical Center; Richmond Virginia
| | - Jay Giri
- Division of Cardiology; Hospital of the University of Pennsylvania; Philadelphia Pennsylvania
| | - Daniel M. Kolansky
- Division of Cardiology; Hospital of the University of Pennsylvania; Philadelphia Pennsylvania
| | - Joseph E. Bavaria
- Division of Cardiovascular Surgery; Hospital of the University of Pennsylvania; Philadelphia Pennsylvania
| | - Zachary M. Gertz
- Division of Cardiology; Virginia Commonwealth University Medical Center; Richmond Virginia
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Alexanderson E, Martínez-Aguilar MM, Juárez-Orozco LE, Jordán-Ríos A, Maury-Ordaz S, Magaña-Bailon E, Meave A. Trivascular coronary artery ectasia: challenging hybrid PET/CT myocardial blood flow measurement. J Nucl Cardiol 2014; 21:1035-8. [PMID: 24664945 DOI: 10.1007/s12350-014-9888-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 03/03/2014] [Indexed: 10/25/2022]
Affiliation(s)
- E Alexanderson
- Departamento de Cardiología Nuclear, Instituto Nacional de Cardiología "Ignacio Chávez", Mexico, Mexico,
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Akturk IF, Biyik I, Yalcin AA, Isiksacan N, Celik O, Ozturk D, Erturk M. Impact of insulin like growth factor-1 in development of coronary artery ectasia. Bosn J Basic Med Sci 2014; 14:244-9. [PMID: 25428678 PMCID: PMC4333962 DOI: 10.17305/bjbms.2014.4.35] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 07/23/2014] [Indexed: 12/13/2022] Open
Abstract
Coronary artery ectasia (CAE) is characterized by inappropriate dilatation of the coronary vasculature. The mechanisms of CAE are not well known. Insulin-like growth factor-1 (IGF-1) may make endothelial cells and smooth muscle cells more sensitive to the effects of growth hormone. In the present study, we hypothesized that IGF-1 may have an impact on the formation of ectasia and aneurysm in arterial system, and aimed to investigate the associations between the presence of CAE and serum IGF-1 levels in patients undergoing coronary angiography. The study included 2.980 subjects undergoing elective diagnostic coronary angiography. We selected 40 patients diagnosed with CAE as CAE group and 44 subjects with absolutely normal coronary arteries were assigned as normal control group. IGF-1 levels were measured in both groups of patients. Groups were similar in terms of age, sex and coronary artery disease risk factors. The serum IGF-1 levels were significantly higher in CAE patients with 109.64 ± 54.64 ng/mL than in controls with 84.76 ± 34.01 ng/mL (p=0.016). HDL levels were lower in ectasia group with 41.5 ± 10.7 mg/dL than controls with 47.7 ± 10.4 mg/dL (p=0.018). By means of logistic regression analysis, high IGF-1 and low HDL levels were found to be independent risk factors for the presence of CAE (p<0.02, p<0.016, respectively). The study revealed that there was a positive correlation between serum IGF-1 levels and presence of CAE, and high IGF-1 levels and low HDL levels were independent risk factors for the presence of CAE. Future studies are needed to confirm these results.
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Affiliation(s)
- Ibrahim Faruk Akturk
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Ismail Biyik
- Department of Cardiology, Usak State Hospital, Usak, Turkey
| | - Ahmet Arif Yalcin
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Nilgun Isiksacan
- Department of Biochemistry, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Omer Celik
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Derya Ozturk
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Erturk
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
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Clinical features of coronary artery ectasia in the elderly. J Geriatr Cardiol 2014; 11:185-91. [PMID: 25278965 PMCID: PMC4178508 DOI: 10.11909/j.issn.1671-5411.2014.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Revised: 06/03/2014] [Accepted: 08/21/2014] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To investigate the incidence, imaging and clinical characteristics in elderly patients with coronary artery ectasia (CAE). METHODS A retrospective analysis was conducted on patients with CAE who underwent coronary angiography between January 2006 and December 2012. According to age, the enrolled patients were divided into two groups (elderly group, age ≥ 65 years; non-elderly group, age < 65 years). The clinical feature, imaging characteristics and the 5-year survival rate of the two groups were compared. RESULTS The prevalence of CAE in elderly patients was 0.33%. Patients in elderly group were found to have significantly higher proportion of female (30.1% vs. 10.1%, P < 0.001), three-vessel disease (60.5% vs. 45.2%, P = 0.003) and localized ectasia (55.0% vs. 40.2%, P = 0.003). In addition, body mass index (20.90 ± 2.71 kg/m(2) vs. 22.31 ± 2.98 kg/m(2), P < 0.001) and percentage of current smokers (45.0% vs. 64.6%, P < 0.001) were significantly lower in elderly group. Cumulative survival curves demonstrated reduced 5-year cumulative survival at the follow-up in the elderly group compared with the non-elderly group (88.0% vs. 96.0%, P = 0.002). But the 5-year event free survival rate failed to show a significant difference between the two groups (31.0% vs. 35.0%, P = 0.311). CONCLUSION The prevalence of CAE in elderly patients was 0.33%, which was about 1/3 of the entire numbers of CAE patients. There were significant differences between the elderly and the non-elderly patients with CAE in terms of coronary artery disease risk factors and coronary artery ectatic characteristics. CAE might be associated with increased mortality risk in the elderly.
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Soto ME, Reyes-Villatoro MA, Márquez R, Cardoso G, Posadas-Sánchez R, Juárez-Orozco LE. Evaluation and Analysis of Plasma Soluble Adhesion Molecules in Patients With Coronary Ectasia and Atherosclerotic Coronary Artery Disease. Arch Med Res 2014; 45:478-83. [DOI: 10.1016/j.arcmed.2014.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Accepted: 06/27/2014] [Indexed: 11/30/2022]
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Prevalence and pattern of abnormal myocardial perfusion in patients with isolated coronary artery ectasia: study by 99mTc-sestamibi radionuclide scintigraphy. Int J Cardiovasc Imaging 2013; 30:425-30. [DOI: 10.1007/s10554-013-0331-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 11/14/2013] [Indexed: 12/17/2022]
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50
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Triantafyllis AS, Kalogeropoulos AS, Rigopoulos AG, Sakadakis EA, Toumpoulis IK, Tsikrikas S, Kremastinos DT, Rizos I. Coronary artery ectasia and inflammatory cytokines: Link with a predominant Th-2 immune response? Cytokine 2013; 64:427-32. [DOI: 10.1016/j.cyto.2013.05.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 04/29/2013] [Accepted: 05/01/2013] [Indexed: 12/21/2022]
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