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Amirpour A, Zavar R, Danesh M, Mirbod SM, Zaker E, Moslemi F, Amini Z, Sadeghi M. Anticoagulant and antiplatelet treatment effects on the incidence of major cardiovascular events in patients with coronary artery ectasia: an updated systematic review. Indian Heart J 2024:S0019-4832(24)00153-6. [PMID: 39009077 DOI: 10.1016/j.ihj.2024.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 04/16/2024] [Accepted: 07/12/2024] [Indexed: 07/17/2024] Open
Abstract
INTRODUCTION Coronary artery ectasia (CAE), widenings in sections of the arteries, is a rare condition found in up to 3-5% of angiography cases. Sometimes recurrence of major adverse cardiac events (MACE) has been reported in the CAE subjects. The present systematic review aims to collect and summarize reports on whether the use of anticoagulants in addition to single antiplatelet/dual antiplatelet therapy (SAPT/DAPT) in CAE patients with significant occlusion/ heavy thrombus is efficient and safe in decreasing the incidence/recurrence of MACE. MATERIAL AND METHODS A systematically comprehensive search was performed covering PubMed, Scopus, ISI Web of Science, and Google Scholar databases. RESULTS Twenty-five studies were found including 20 case reports, four case series, and one randomized clinical trial. Of 20 case reports 15 were male (75%), and five were female (25%). Of the four the case series, all showed positive outcomes after DAPT plus anticoagulant in more than 50% of patients; two took only DAPT and 13 took anticoagulant ± DAPT, and five compared both. Cases received DAPT only experienced recurrences of MACE. The other cases were uneventful with less MACE and better outcomes after the use of anticoagulant ± DAPT. Results of these case-series included 457 CAE patients showed that more than 80% of subjects were male, and in all studies tailored pharmacological interventions, including antiplatelet and anticoagulant (warfarin) therapies, resulted in less MACE and mortality. CONCLUSION It can be concluded that antiplatelet (SAPT/DAPT) must be applied in combination with anticoagulants to provide more efficient protection against MACE in CAE patients. However, further high-quality randomized clinical trials are needed to confirm the results.
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Affiliation(s)
- Afshin Amirpour
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reihaneh Zavar
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Manizheh Danesh
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Erfan Zaker
- Department of Genetics and Molecular biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Moslemi
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Zahra Amini
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoumeh Sadeghi
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Gurgoglione FL, Benatti G, Vignali L, Tadonio I, Magnani G, Denegri A, Lazzeroni D, Tuttolomondo D, De Gregorio M, Indrigo E, Signoretta G, Abbati V, Nicolini F, Ardissino D, Solinas E, Niccoli G. Prognostic role of coronary artery ectasia in patients with nonobstructive coronary artery disease. J Cardiovasc Med (Hagerstown) 2024; 25:179-185. [PMID: 38305146 DOI: 10.2459/jcm.0000000000001592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
AIMS Coronary artery ectasia (CAE) has been linked to the occurrence of adverse events in patients with ischemia/angina and no obstructive coronary arteries (INOCA/ANOCA), while the relationship between CAE and myocardial infarction with nonobstructive coronary arteries (MINOCA) has been poorly investigated. In our study we aimed at assessing differences in clinical, angiographic and prognostic features among patients with CAE and MINOCA vs. INOCA/ANOCA presentation. METHODS Patients with angiographic evidence of CAE were enrolled at the University Hospital of Parma and divided into MINOCA vs. INOCA/ANOCA presentation. Clinical and quantitative angiographic information was recorded and the incidence of major adverse cardiovascular events (MACE) was assessed at follow-up. RESULTS We enrolled a total of 97 patients: 49 (50.5%) with MINOCA and 48 (49.5%) with INOCA/ANOCA presentation. The presentation with MINOCA was associated with a higher frequency of inflammatory diseases ( P = 0.041), multivessel CAE ( P = 0.030) and thrombolysis in myocardial infarction (TIMI) flow < 3 ( P = 0.013). At a median follow-up of 38 months, patients with MINOCA had a significantly higher incidence of MACE compared with those with INOCA/ANOCA [8 (16.3%) vs. 2 (4.2%), P = 0.045], mainly driven by a higher rate of nonfatal MI [5 (10.2%) vs. 0 (0.0%), P = 0.023]. At multivariate Cox regression analysis, the presentation with MINOCA ( P = 0.039) and the presence of TIMI flow <3 ( P = 0.037) were independent predictors of MACE at follow-up. CONCLUSION Among a cohort of patients with CAE and nonobstructive coronary artery disease, the presentation with MINOCA predicted a worse outcome.
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Affiliation(s)
| | | | - Luigi Vignali
- Division of Cardiology, Parma University Hospital, Parma
| | - Iacopo Tadonio
- Division of Cardiology, Parma University Hospital, Parma
| | - Giulia Magnani
- Division of Cardiology, Parma University Hospital, Parma
| | - Andrea Denegri
- Division of Cardiology, Parma University Hospital, Parma
| | | | | | | | | | | | | | - Francesco Nicolini
- Division of Cardio surgery, University of Parma, Parma University Hospital, Parma, Italy
| | - Diego Ardissino
- Division of Cardiology, University of Parma
- Division of Cardiology, Parma University Hospital, Parma
| | - Emilia Solinas
- Division of Cardiology, Parma University Hospital, Parma
| | - Giampaolo Niccoli
- Division of Cardiology, University of Parma
- Division of Cardiology, Parma University Hospital, Parma
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Vieyra-Herrera G, García-Navarrete MG, Dámazo-Escobedo CA, González-Pacheco H, Rodríguez-Chavez LL, Silva-Ruz C. Outlook of coronary ectasia at the National Institute of Cardiology Ignacio Chávez: a cross-sectional study. ARCHIVOS DE CARDIOLOGIA DE MEXICO 2023; 93:197-202. [PMID: 37037216 PMCID: PMC10161814 DOI: 10.24875/acm.21000380] [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: 12/06/2021] [Accepted: 05/13/2022] [Indexed: 04/08/2023] Open
Abstract
INTRODUCTION Coronary Ectasia (CE) is a pathological remodeling with a low worldwide prevalence. It is defined as a diffuse dilatation greater than 1.5 times the diameter of the adjacent segments of the same or different coronary arteries. OBJECTIVE To document the clinical and angiographic characteristics, and medical treatment at the discharge of patients diagnosed with coronary ectasia who attended the National Institute of Cardiology (INC). METHODS Cross-sectional study with a non-experimental descriptive design, with a non-probabilistic convenience sampling. RESULTS Of 69 patients who attended the INC with a diagnosis of CD, most were men, with a mean age of 56 + 11 years, the most common coronary risk factor in patients with CE was smoking 58% (40); it was associated mostly with an acute myocardial infarction ST-segment elevation (STEMI) 65.2% (45), of frequent location in the lower face 40% (18), correlated with the most affected artery is the Right Coronary Artery (CD) 69.6% (48), followed by the circumflex (Cx) 56.5% (39). A mean LVEF of 47 + 9.72 was evident within the ventricular function. As well as the preferential use of dual antiplatelet therapy with anticoagulant (DAP + OAC) in 58% (40) at the discharge of each patient from the INC. CONCLUSION CE is a not uncommon pathological remodeling in INC. This study showed that STEMI is the most typical manifestation of CE, diagnostic coronary angiography identified a type 3 Markis, so a low rate of mortality and recurrence of cardiovascular events would be expected, and despite the lack of consensus on the ideal therapy, at the INC individualized treatment is preferred, recommending lifestyle changes, and using triple therapy (DAP + OAC) as a medical treatment only at the time of patient discharge.
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Affiliation(s)
- Gerardo Vieyra-Herrera
- Servicio de Hospitalización, Departamento de Cardiología Adultos, Instituto Nacional de Cardiología Ignacio Chávez
| | | | | | - Héctor González-Pacheco
- Unidad Coronaria, Instituto Nacional de Cardiología Ignacio Chávez. Ciudad de México, México
| | - Laura L. Rodríguez-Chavez
- Servicio de Hospitalización, Departamento de Cardiología Adultos, Instituto Nacional de Cardiología Ignacio Chávez
| | - Carlos Silva-Ruz
- Servicio de Hospitalización, Departamento de Cardiología Adultos, Instituto Nacional de Cardiología Ignacio Chávez
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Araiza-Garaygordobil D, Gopar-Nieto R, Sierra-Lara Martínez D, Belderrain-Morales N, Sarabia-Chao V, Alfaro-Ponce DL, Ontiveros-Mercado H, Mendoza-García S, Altamirano-Castillo A, Martinez-Amezcua P, Cabello-López A, Briseño-De la Cruz JL, Ruiz-Beltrán M, Martínez-Ríos MA, Piña-Reyna Y, Gonzalez-Pacheco H, Arias-Mendoza A. Dual Antiplatelet Therapy Versus Antiplatelet Monotherapy Plus Oral Anticoagulation in Patients with Acute Coronary Syndrome and Coronary Artery Ectasia: Design and Rationale of OVER-TIME Randomized Clinical Trial. High Blood Press Cardiovasc Prev 2022; 29:463-468. [PMID: 35904750 DOI: 10.1007/s40292-022-00535-4] [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] [Received: 05/24/2022] [Accepted: 07/18/2022] [Indexed: 10/16/2022] Open
Abstract
INTRODUCTION The optimal anti-thrombotic therapy to prevent recurrent ischemic events in patients with acute coronary syndrome and coronary artery ectasia (CAE) remains unclear. AIM To assess the efficacy and safety of antiplatelet plus anticoagulant therapy versus dual antiplatelet therapy in patients with acute coronary syndromes and coronary artery ectasia. METHODS OVER-TIME is an investigator initiated, exploratory, open label, single center, randomized clinical trial comparing dual antiplatelet therapy (acetyl-salicylic acid plus a P2Y12 inhibitor) with the combination of an antiplatelet monotherapy (a P2Y12 inhibitor) plus a low dose anticoagulant (rivaroxaban, 15mg oral dose) for the prevention of recurrent ischemic events among patients with CAE. We aim to enroll approximately 60 patients with CAE and acute coronary syndromes. After recruitment, patients are randomized to (a) standard of care (dual antiplatelet regimen) or (b) the combination of antiplatelet monotherapy and low dose anticoagulant. Patients will be followed for at least 12 months. The OVER-TIME study aims to assess the efficacy of the regimen in prevention of major cardiovascular events and its security in bleeding events in acute coronary syndromes among patients with CAE. Expected results and conclusions: OVER-TIME is the first randomized controlled trial to assess different antithrombotic strategies in patients with CAE and acute coronary syndrome, and its results will offer preliminary data for the prevention of major cardiovascular events and bleeding events in this group of patients. TRIAL REGISTRATION NUMBER NCT05233124 (ClinicalTrials.gov), date of registration: February 10, 2022.
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Affiliation(s)
- Diego Araiza-Garaygordobil
- Coronary Care Unit, National Institute of Cardiology "Ignacio Chávez", Juan Badiano 1, Belisario Dominguez Sección XVI, Tlalpan, 14030, Mexico City, Mexico.
| | - Rodrigo Gopar-Nieto
- Coronary Care Unit, National Institute of Cardiology "Ignacio Chávez", Juan Badiano 1, Belisario Dominguez Sección XVI, Tlalpan, 14030, Mexico City, Mexico
| | - Daniel Sierra-Lara Martínez
- Coronary Care Unit, National Institute of Cardiology "Ignacio Chávez", Juan Badiano 1, Belisario Dominguez Sección XVI, Tlalpan, 14030, Mexico City, Mexico
| | - Nallely Belderrain-Morales
- Coronary Care Unit, National Institute of Cardiology "Ignacio Chávez", Juan Badiano 1, Belisario Dominguez Sección XVI, Tlalpan, 14030, Mexico City, Mexico
| | - Vianney Sarabia-Chao
- Coronary Care Unit, National Institute of Cardiology "Ignacio Chávez", Juan Badiano 1, Belisario Dominguez Sección XVI, Tlalpan, 14030, Mexico City, Mexico
| | - Diana Laura Alfaro-Ponce
- Coronary Care Unit, National Institute of Cardiology "Ignacio Chávez", Juan Badiano 1, Belisario Dominguez Sección XVI, Tlalpan, 14030, Mexico City, Mexico
| | - Heriberto Ontiveros-Mercado
- Coronary Care Unit, National Institute of Cardiology "Ignacio Chávez", Juan Badiano 1, Belisario Dominguez Sección XVI, Tlalpan, 14030, Mexico City, Mexico
| | - Salvador Mendoza-García
- Coronary Care Unit, National Institute of Cardiology "Ignacio Chávez", Juan Badiano 1, Belisario Dominguez Sección XVI, Tlalpan, 14030, Mexico City, Mexico
| | - Alfredo Altamirano-Castillo
- Coronary Care Unit, National Institute of Cardiology "Ignacio Chávez", Juan Badiano 1, Belisario Dominguez Sección XVI, Tlalpan, 14030, Mexico City, Mexico
| | - Pablo Martinez-Amezcua
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, USA
| | - Alejandro Cabello-López
- Occupational Health Research Unit, Centro Médico Nacional Siglo XXI, Mexican Institute of Social Security, Mexico City, Mexico
| | - Jose Luis Briseño-De la Cruz
- Coronary Care Unit, National Institute of Cardiology "Ignacio Chávez", Juan Badiano 1, Belisario Dominguez Sección XVI, Tlalpan, 14030, Mexico City, Mexico
| | - Maximiliano Ruiz-Beltrán
- Coronary Care Unit, National Institute of Cardiology "Ignacio Chávez", Juan Badiano 1, Belisario Dominguez Sección XVI, Tlalpan, 14030, Mexico City, Mexico
| | | | - Yigal Piña-Reyna
- Interventional Cardiology, National Institute of Cardiology "Ignacio Chávez", Mexico City, Mexico
| | - Hector Gonzalez-Pacheco
- Coronary Care Unit, National Institute of Cardiology "Ignacio Chávez", Juan Badiano 1, Belisario Dominguez Sección XVI, Tlalpan, 14030, Mexico City, Mexico
| | - Alexandra Arias-Mendoza
- Coronary Care Unit, National Institute of Cardiology "Ignacio Chávez", Juan Badiano 1, Belisario Dominguez Sección XVI, Tlalpan, 14030, Mexico City, Mexico
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Liu RF, Gao XY, Liang SW, Zhao HQ. Antithrombotic treatment strategy for patients with coronary artery ectasia and acute myocardial infarction: A case report. World J Clin Cases 2022; 10:3936-3943. [PMID: 35647140 PMCID: PMC9100716 DOI: 10.12998/wjcc.v10.i12.3936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 01/19/2022] [Accepted: 03/06/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND There is no consensus on the antithrombotic treatment strategy for patients with coronary artery ectasia (CAE).
CASE SUMMARY This case reports the dynamic observation of a patient for 48 mo after a diagnosis of CAE with acute myocardial infarction (AMI). The first antithrombotic agents used were aspirin (100 mg/d) and clopidogrel (75 mg/d). During the sixth month of observation, a second AMI occurred involving the same culprit vessel; therefore, antithrombotic agents were changed to aspirin (100 mg/d) and ticagrelor (90 mg twice per day). Twelve months after the second AMI, an attempt to reduce the dosage ticagrelor failed; therefore the original dose was continued. The CAE was relatively stable during the following 4 years.
CONCLUSION This case indicates that a combination of aspirin and ticagrelor may be more effective for CAE patients with AMI than aspirin and clopidogrel.
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Affiliation(s)
- Rui-Feng Liu
- Department of Cardiology, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing 100050, China
| | - Xiang-Yu Gao
- Department of Cardiology, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing 100050, China
| | - Si-Wen Liang
- Department of Cardiology, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing 100050, China
| | - Hui-Qiang Zhao
- Department of Cardiology, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing 100050, China
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Liu R, Zhao H, Gao X, Liang S. Is Coronary Artery Ectasia a Progressive Disease? A Self-Controlled Retrospective Cohort Study. Front Cardiovasc Med 2021; 8:774597. [PMID: 34938789 PMCID: PMC8685394 DOI: 10.3389/fcvm.2021.774597] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 11/15/2021] [Indexed: 12/03/2022] Open
Abstract
Objective: It is essential to understand whether coronary artery ectasia (CAE) progresses over time because the patients might be under the risk of coronary rupture, and stent implant should be avoided if ectatic changes progress. Methods: A consecutive series of 99 CAE patients who had undergone coronary angiography at least twice were enrolled and followed up for 1–16 years until they received a second angiogram. Subjects were divided into two groups (1–5 vs. 5–16 years of follow-up), then the basic clinical characteristics and coronary artery images were compared over time. Results: (1) All CAE patients exhibited atherosclerosis, and a majority presented with acute myocardial infarction. Most baseline clinical characteristics were relatively stable. (2) Atherosclerosis (indicated by the distribution of stenosis in coronary vessels) and the Gensini scores progressed significantly. Ectasia extent showed minimal changes as indicated by blood vessel involvement, Markis type, coronary blood flow, ectasia diameter, and ectasia length. (3) Multilinear regression analysis revealed that the underlying factors related to stenosis evolution indicated by fold of Gensini score were: longer time interval, lower baseline Gensini score, and higher hypersensitive C-reactive protein concentration. (4) There was a relationship between the ectatic diameter and the extent of stenosis. Conclusions: For CAE patients with atherosclerosis followed for 1–16 years, there was minimal CAE progression, while the atherosclerosis progressed and the ectasia extent was related to degree of stenosis. The results indicate that prevention and treatment of atherosclerotic changes might have more clinical significance than addressing ectatic changes.
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Affiliation(s)
- Ruifeng Liu
- Department of Cardiology, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing, China
| | - Huiqiang Zhao
- Department of Cardiology, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing, China
| | - Xiangyu Gao
- Department of Cardiology, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing, China
| | - Siwen Liang
- Department of Cardiology, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing, China
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Khedr A, Neupane B, Proskuriakova E, Jada K, Kakieu Djossi S, Mostafa JA. Pharmacologic Management of Coronary Artery Ectasia. Cureus 2021; 13:e17832. [PMID: 34660041 PMCID: PMC8502747 DOI: 10.7759/cureus.17832] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 09/08/2021] [Indexed: 01/24/2023] Open
Abstract
Coronary artery ectasia (CAE) is a rare form of aneurysmal coronary heart disease. It is defined as a dilatation of the coronary artery by more than one-third of its length and with a diameter 1.5 times of a normal coronary artery adjacent to it. This condition increases the risk of angina pectoris and acute coronary syndrome. Hence, we discuss the pharmacologic options for primary and secondary prevention of CAE complications. Antiplatelets such as aspirin are considered the mainstay of treatment in patients with CAE. Anticoagulants such as warfarin are warranted on a case-by-case basis to prevent thrombus formation depending on the presence of concomitant obstructive coronary artery disease and the patient’s risk of bleeding. Since atherosclerosis is the most common cause of CAE, statins are indicated in all patients for primary prevention. Angiotensin-converting enzyme (ACE) inhibitors may be indicated, especially in hypertensive patients, due to their anti-inflammatory properties. Beta-blockers may be indicated due to their antihypertensive and anti-ischemic effects. Calcium (Ca) channel blockers may be needed to prevent coronary vasospasm. Nitrates are generally contraindicated as they may lead to worsening of symptoms. Other antianginal medications such as trimetazidine can improve exercise tolerance with no reported adverse events in these patients.
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Affiliation(s)
- Anwar Khedr
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Bandana Neupane
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Ekaterina Proskuriakova
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Keji Jada
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | | | - Jihan A Mostafa
- Psychiatry, Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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Fan CH, Hao Y, Liu YH, Li XL, Huang ZH, Luo Y, Li RL. Anti-inflammatory effects of rosuvastatin treatment on coronary artery ectasia patients of different age groups. BMC Cardiovasc Disord 2020; 20:330. [PMID: 32652935 PMCID: PMC7353781 DOI: 10.1186/s12872-020-01604-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 06/26/2020] [Indexed: 02/06/2023] Open
Abstract
Background Coronary artery ectasia (CAE) is an angiographic finding of abnormal coronary dilatation. Inflammation plays a major role in all phases of atherosclerosis. We investigated the relationship between CAE and serum high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) levels to test our hypothesis that patient age is associated with the efficacy of anti-inflammatory therapy for CAE. Methods We conducted a prospective analysis of 217 patients with CAE treated at the Department of Cardiology, Shanghai East Hospital, Ji’an Campus and the Baoshan People’s Hospital, from January 1, 2015 to July 30, 2019. Baseline data of patients, including sex; age; and history of hypertension, hyperlipidemia, and diabetes, were collected from patient medical records. Study participants were grouped by age as follows: CAE-A (n = 60, age ≤ 50 years), CAE-B (n = 83, 50 years <age ≤ 70 years), and CAE-C (n = 74, age > 70). Additionally, there was a control (NC) group (n = 73) with normal coronary arteries. Results All patients received oral rosuvastatin therapy (10 mg, QN quaque nocte) when they were diagnosed with CAE and maintained good follow-up, with a loss rate of 0.0% at the end of the 6-month follow-up. The NC group received regular symptom-relieving treatments and rosuvastatin therapy. Of these four groups, the inflammatory markers, hs-CRP and IL-6, were significantly higher in patients with CAE than in the NCs (p < 0.05). Post-hoc tests showed that hs-CRP and Il-6 levels had significant differences between the CAE-A and CAE-C groups (P = 0.048, P = 0.025). Logistic regression analysis showed that hs-CRP (OR = 1.782, 95% CI: 1.124–2.014, P = 0.021) and IL-6 (OR = 1.584, 95% CI: 1.112–1.986, P = 0.030) were independent predictors of CAE. The inflammatory markers were higher in the CAE-A group than in the CAE-B group and higher in the CAE-B group than in the CAE-C group. Follow-up after 6 months of rosuvastatin therapy showed a significantly greater reduction in hs-CRP and IL-6 levels in the CAE-A group than in the CAE-B group, which again were greater in the CAE-B group than in the CAE-C group. Conclusions Anti-inflammatory therapy using rosuvastatin was more effective in younger CAE patients, indicating the need for early statin therapy in CAE.
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Affiliation(s)
- Cheng-Hui Fan
- Department of Cardiology, Shanghai East Hospital, Tongji University, 1800 Yuntai Rd, Shanghai, 200126, People's Republic of China
| | - Ying Hao
- Department of Cardiology, Shanghai East Hospital, Tongji University, 1800 Yuntai Rd, Shanghai, 200126, People's Republic of China
| | - Yong-Hua Liu
- Cardiovascular Medicine of Baoshan People's Hospital of the Yunnan Province, Kunming Medical University, Baoshan, 678000, People's Republic of China
| | - Xiao-Lin Li
- Department of Cardiology, Shanghai East Hospital (Ji'an Campus), Medical School, Jinggangshan University, Ji'an, 343009, People's Republic of China
| | - Zhen-Hao Huang
- Department of Cardiology, Shanghai East Hospital, Tongji University, 1800 Yuntai Rd, Shanghai, 200126, People's Republic of China
| | - Yu Luo
- Department of Cardiology, Shanghai East Hospital, Tongji University, 1800 Yuntai Rd, Shanghai, 200126, People's Republic of China.
| | - Rui-Lin Li
- Department of Cardiology, Shanghai East Hospital, Tongji University, 1800 Yuntai Rd, Shanghai, 200126, People's Republic of China.
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