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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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Coronary Artery Ectasia: Review of the Non-Atherosclerotic Molecular and Pathophysiologic Concepts. Int J Mol Sci 2022; 23:ijms23095195. [PMID: 35563583 PMCID: PMC9103542 DOI: 10.3390/ijms23095195] [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: 03/17/2022] [Revised: 05/02/2022] [Accepted: 05/04/2022] [Indexed: 11/25/2022] Open
Abstract
Coronary artery ectasia (CAE) is frequently encountered in clinical practice, conjointly with atherosclerotic CAD (CAD). Given the overlapping cardiovascular risk factors for patients with concomitant CAE and atherosclerotic CAD, a common underlying pathophysiology is often postulated. However, coronary artery ectasia may arise independently, as isolated (pure) CAE, thereby raising suspicions of an alternative mechanism. Herein, we review the existing evidence for the pathophysiology of CAE in order to help direct management strategies towards enhanced detection and treatment.
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Vrachatis DA, Papathanasiou KA, Kazantzis D, Sanz-Sánchez J, Giotaki SG, Raisakis K, Kaoukis A, Kossyvakis C, Deftereos G, Reimers B, Avramides D, Siasos G, Cleman M, Giannopoulos G, Lansky A, Deftereos S. Inflammatory Biomarkers in Coronary Artery Ectasia: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2022; 12:diagnostics12051026. [PMID: 35626182 PMCID: PMC9140118 DOI: 10.3390/diagnostics12051026] [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: 03/26/2022] [Revised: 04/10/2022] [Accepted: 04/14/2022] [Indexed: 12/23/2022] Open
Abstract
Isolated coronary artery ectasia (CAE) is a relatively rare clinical entity, the pathogenesis of which is poorly understood. More and more evidence is accumulating to suggest a critical inflammatory component. We aimed to elucidate any association between neutrophil to lymphocyte ratio and coronary artery ectasia. A systematic MEDLINE database, ClinicalTrials.gov, medRxiv, Scopus and Cochrane Library search was conducted: 50 studies were deemed relevant, reporting on difference in NLR levels between CAE patients and controls (primary endpoint) and/or on high-sensitive CRP, IL-6, TNF-a and RDW levels (secondary endpoint), and were included in our final analysis. (PROSPERO registration number: CRD42021224195). All inflammatory biomarkers under investigation were found higher in coronary artery ectasia patients as compared to healthy controls (NLR; SMD = 0.73; 95% CI: 0.27–1.20, hs-CRP; SMD = 0.96; 95% CI: 0.64–1.28, IL-6; SMD = 2.68; 95% CI: 0.95–4.41, TNF-a; SMD = 0.50; 95% CI: 0.24–0.75, RDW; SMD = 0.56; 95% CI: 0.26–0.87). The main limitations inherent in this analysis are small case-control studies of moderate quality and high statistical heterogeneity. Our findings underscore that inflammatory dysregulation is implicated in coronary artery ectasia and merits further investigation.
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Affiliation(s)
- Dimitrios A. Vrachatis
- Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (D.A.V.); (K.A.P.); (D.K.); (S.G.G.); (G.S.)
| | - Konstantinos A. Papathanasiou
- Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (D.A.V.); (K.A.P.); (D.K.); (S.G.G.); (G.S.)
| | - Dimitrios Kazantzis
- Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (D.A.V.); (K.A.P.); (D.K.); (S.G.G.); (G.S.)
| | - Jorge Sanz-Sánchez
- Division of Cardiology, Hospital Universitario y Politécnico La Fe, 46026 Valencia, Spain;
- Centro de Investigacion Biomédica en Red (CIBERCV), 28029 Madrid, Spain
| | - Sotiria G. Giotaki
- Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (D.A.V.); (K.A.P.); (D.K.); (S.G.G.); (G.S.)
| | - Konstantinos Raisakis
- Deparment of Cardiology, General Hospital of Athens “G.Gennimatas”, 11527 Athens, Greece; (K.R.); (A.K.); (C.K.); (G.D.); (D.A.)
| | - Andreas Kaoukis
- Deparment of Cardiology, General Hospital of Athens “G.Gennimatas”, 11527 Athens, Greece; (K.R.); (A.K.); (C.K.); (G.D.); (D.A.)
| | - Charalampos Kossyvakis
- Deparment of Cardiology, General Hospital of Athens “G.Gennimatas”, 11527 Athens, Greece; (K.R.); (A.K.); (C.K.); (G.D.); (D.A.)
| | - Gerasimos Deftereos
- Deparment of Cardiology, General Hospital of Athens “G.Gennimatas”, 11527 Athens, Greece; (K.R.); (A.K.); (C.K.); (G.D.); (D.A.)
| | - Bernhard Reimers
- Humanitas Clinical and Research Center IRCCS, 20089 Milan, Italy;
| | - Dimitrios Avramides
- Deparment of Cardiology, General Hospital of Athens “G.Gennimatas”, 11527 Athens, Greece; (K.R.); (A.K.); (C.K.); (G.D.); (D.A.)
| | - Gerasimos Siasos
- Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (D.A.V.); (K.A.P.); (D.K.); (S.G.G.); (G.S.)
| | - Michael Cleman
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT 06510, USA; (M.C.); (A.L.)
| | - George Giannopoulos
- Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Alexandra Lansky
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT 06510, USA; (M.C.); (A.L.)
| | - Spyridon Deftereos
- Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (D.A.V.); (K.A.P.); (D.K.); (S.G.G.); (G.S.)
- Correspondence: ; Tel.: +30-2105832355
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Juan T, Chao-Ying C, Hua-Rong L, Ling W. Rare cause of coronary artery ectasia in children: A case report of methylmalonic acidemia with hyperhomocysteinemia. Front Pediatr 2022; 10:917734. [PMID: 35935352 PMCID: PMC9354574 DOI: 10.3389/fped.2022.917734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 07/07/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Methylmalonic acidemia (MMA) with hyperhomocysteinemia is caused by cobalamin deficiency, mainly due to disturbance of cobalamin C (cblC) metabolism. Its clinical manifestations involve many organs. However, cases of coronary artery ectasia have been rarely reported. CASE PRESENTATION Here, we report the case of a 4-year-old girl who was hospitalized mainly because of pallor, brown urine, and fatigue, followed by hypertension, renal insufficiency, hemolytic anemia, cardiac enlargement, cardiac insufficiency, and coronary artery ectasia. Thrombotic microangiopathy (TMA) was confirmed by renal pathological examination. Metabolic examination showed hyperhomocysteinemia and methylmalonic aciduria. Furthermore, genetic assessment confirmed MMACHC gene variant, which confirmed the final diagnosis of a cblC defect. Intramuscular injection of hydroxy-cobalamin, oral medications of betaine, levocarnitine, folic acid, and aspirin were administered. Three months later, the patient's condition was significantly improved. Anemia was corrected, and the renal function was normal. Heart size, cardiac function, and coronary artery structure completely returned to normal. CONCLUSION The clinical manifestation of cblC deficiency is atypical. This critical condition may be associated with multiple organ involvement. A rare complication, coronary artery ectasia, can also occur. Early identification, careful evaluation, and appropriate treatment are crucially important for the improvement of this disease prognosis.
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Affiliation(s)
- Tu Juan
- Department of Nephrology, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China
| | - Chen Chao-Ying
- Department of Nephrology, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China
| | - Li Hua-Rong
- Department of Nephrology, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China
| | - Wan Ling
- Department of Nephrology, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China
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Toprak K, Kaplangoray M, Palice A. The Impact of C-Peptide and Diabetes Mellitus on Coronary Ectasia and Effect of Coronary Ectasia and C-Peptide on Long-Term Outcomes: A Retrospective Cohort Study. Int J Clin Pract 2022; 2022:7910566. [PMID: 36277470 PMCID: PMC9569235 DOI: 10.1155/2022/7910566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 09/12/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Coronary artery ectasia (CAE) is an entity frequently associated with atherosclerotic coronary artery disease (CAD) in clinical practice. Although it has common risk factors with atherosclerotic CAD in its development, the pathophysiology of CAE is not fully known and it is not seen in every CAD suggesting that different determinants may play a pivotal role in the development of CAD. This study aimed to reveal the impact of C-peptide and diabetes mellitus (DM) on CAE and the effect of C-peptide and coronary ectasia on long-term outcomes in patients who underwent coronary angiography. METHODS A total of 6611 patients who underwent coronary angiography were followed up retrospectively, and their major adverse cardiovascular event (MACE) status of an average of sixty months was recorded. According to their angiographic features, the patients were divided into two groups those with and without CAE. MACE development was accepted as the primary endpoint. RESULTS A total of 552 patients had CAE and MACE developed in 573 patients. Patients with CAE and higher C-peptide levels (Q4 + Q3) showed higher rates of MACE as compared to those without CAE and lower C-peptide levels (Q1 + Q2) (20.8% vs 7.6%; 70.1% vs 29.1%; p < 0.001, for both of them). In multivariate regression analysis, high C-peptide levels were determined as an independent risk factor for CAE (OR 2.417; 95% CI 2.212-2.641; p < 0.001). The Kaplan-Meier cumulative survival curves showed that the risks for MACE increased as the C-peptide levels increased. The Cox regression analysis for 5-years MACE related to the plasma C-peptide levels and presence of CAE, C-peptide, and CAE were found to be independent predictors of MACE (HR = 1.255, 95% CI: 1.164-1.336, p < 0.001 and HR = 1.012, 95% CI: 1.002-1.023, p=0.026, respectively). CONCLUSION Our study revealed that a high C-peptide level is an independent risk factor for CAE and that CAE and C-peptide are independent predictors for the development of MACE.
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Affiliation(s)
- Kenan Toprak
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | | | - Ali Palice
- Mehmet Akif İnan Training and Research Hospital, Sanliurfa, Turkey
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Association of systemic immune-inflammation index (SII) with presence of isolated coronary artery ectasia. ARCHIVES OF MEDICAL SCIENCES. ATHEROSCLEROTIC DISEASES 2021; 6:e152-e157. [PMID: 34703943 PMCID: PMC8525247 DOI: 10.5114/amsad.2021.109253] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 07/21/2021] [Indexed: 01/02/2023]
Abstract
Introduction The systemic immune-inflammation index (SII) has been developed based on the calculation of N×P/L (N, P and L represent neutrophil count, platelet count and lymphocyte count, respectively), and it is widely used as a marker of inflammation and an indicator of cardiovascular outcomes in patients with coronary artery disease. We examined a possible association between SII and the presence of isolated coronary artery ectasia (CAE). Material and methods In this retrospective case-control study, a total of 4400 patients who underwent elective coronary angiography between June 2015 and July 2020 were retrospectively screened. Following the application of exclusion criteria, our study population consisted of 139 CAE patients and 141 age- and gender-matched subjects who proved to have normal coronary angiograms. Results The median value of SII was found to be statistically significantly higher in patients with CAE (p < 0.01). SII level ≥ 809 measured on admission had 48% sensitivity and 82% specificity in predicting isolated CAE in ROC curve analysis. In this ROC analysis, the predictive powers of neutrophil-to-lymphocyte ratio (NLR) and SII in determining the presence of ectasia were compared, and the predictive power of SII was significantly stronger than N/L ratio (p = 0.003). In the multivariate analysis, hyperlipidaemia (OR = 1.978, 95% CI: 1.168–3.349, p = 0.01), smoking (OR = 1.86, 95% CI: 1.090–3.127, p = 0.023) N/L ratio (OR = 1.192, 95% CI: (1.114–1.997, p = 0.07) and SII (OR = 1.002, 95% CI: 1.001–1.003, p < 0.01) were independent predictors of the presence of isolated CAE. Conclusions SII is a readily available clinical laboratory value that is associated with the presence of isolated CAE. Our findings may indicate a common pathophysiological mechanism between CAE and coronary artery disease.
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Karakus A, Tütüncü A, Çamcı S, Uğuz B, Özmen G, Arı H, Demir M. A New Perspective for Isolated Coronary Artery Ectasia: Cystatin C. Cureus 2020; 12:e11053. [PMID: 33224650 PMCID: PMC7676437 DOI: 10.7759/cureus.11053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction The pathophysiology of isolated coronary artery ectasia (iCAE) has not been clearly identified, although multiple abnormalities, including arteritis, endothelial dysfunction, and vascular destruction, have been reported. In this study, we aimed to analyze serum cystatin C concentrations in patients with iCAE and controls. Methods Forty-seven patients with iCAE (mean age: 55.9 ± 11.5) and 32 individuals with normal coronary angiography (mean age: 57.8.1 ± 9.6) were included in the study. Plasma cystatin C levels were measured by using the principle of particle-enhanced turbidimetric immunoassay (PETIA). Results Serum cystatin C concentrations were significantly lower in patients with iCAE compared with the control group (0.98 ± 0.17 mg/L versus 1.17 ± 2.6 mg/L, p-value = 0.001). A significantly positive relationship was found between serum cystatin C levels and creatinine and high-sensitivity C-reactive protein (hs-CRP) levels in both groups (r-value = 0.288, p-value = 0.005, r-value = 0.143, p-value = 0.007, respectively). In multivariate logistic regression analysis, serum cystatin C level found to be a significant predictor for the presence of iCAE (OR: 0.837, CI: 95% (0.341 - 1.637), p-value = 0.013). Receiver operating characteristic (ROC) analysis determined that a cystatin C value < 1.02 mg/L had a sensitivity of 56% and a specificity of 78% for the prediction of ectasia. Conclusion We conclude that cystatin C independently can be a useful predictor for the presence of iCAE.
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Franco-Peláez JA, Martín-Reyes R, Pello-Lázaro AM, Aceña Á, Lorenzo Ó, Martín-Ventura JL, Blanco-Colio L, González-Casaus ML, Hernández-González I, Carda R, Martín-Mariscal ML, Egido J, Tuñón J. Monocyte Chemoattractant Protein-1 Is an Independent Predictor of Coronary Artery Ectasia in Patients with Acute Coronary Syndrome. J Clin Med 2020; 9:jcm9093037. [PMID: 32967202 PMCID: PMC7563376 DOI: 10.3390/jcm9093037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 09/14/2020] [Accepted: 09/17/2020] [Indexed: 11/25/2022] Open
Abstract
Our purpose was to assess a possible association of inflammatory, lipid and mineral metabolism biomarkers with coronary artery ectasia (CAE) and to determine a possible association of this with acute atherotrombotic events (AAT). We studied 270 patients who underwent coronary angiography during an acute coronary syndrome 6 months before. Plasma levels of several biomarkers were assessed, and patients were followed during a median of 5.35 (3.88–6.65) years. Two interventional cardiologists reviewed the coronary angiograms, diagnosing CAE according to previously published criteria in 23 patients (8.5%). Multivariate binary logistic regression analysis was used to search for independent predictors of CAE. Multivariate analysis revealed that, aside from gender and a diagnosis of dyslipidemia, only monocyte chemoattractant protein-1 (MCP-1) (OR = 2.25, 95%CI = (1.35–3.76) for each increase of 100 pg/mL, p = 0.001) was independent predictor of CAE, whereas mineral metabolism markers or proprotein convertase subtilisin/kexin type 9 were not. Moreover, CAE was a strong predictor of AAT during follow-up after adjustment for other clinically relevant variables (HR = 2.67, 95%CI = (1.22–5.82), p = 0.013). This is the first report showing that MCP-1 is an independent predictor of CAE, suggesting that CAE and coronary artery disease may share pathogenic mechanisms. Furthermore, CAE was associated with an increased incidence of AAT.
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Affiliation(s)
- Juan Antonio Franco-Peláez
- Department of Cardiology, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz, 28040 Madrid, Spain; (A.M.P.-L.); (Á.A.); (R.C.); (J.T.)
- Department of Medicine, Autónoma University, 28049 Madrid, Spain; (Ó.L.); (J.L.M.-V.); (J.E.)
- Correspondence: ; Tel.: +34-91-5504-800
| | | | - Ana María Pello-Lázaro
- Department of Cardiology, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz, 28040 Madrid, Spain; (A.M.P.-L.); (Á.A.); (R.C.); (J.T.)
- Department of Medicine, Autónoma University, 28049 Madrid, Spain; (Ó.L.); (J.L.M.-V.); (J.E.)
| | - Álvaro Aceña
- Department of Cardiology, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz, 28040 Madrid, Spain; (A.M.P.-L.); (Á.A.); (R.C.); (J.T.)
- Department of Medicine, Autónoma University, 28049 Madrid, Spain; (Ó.L.); (J.L.M.-V.); (J.E.)
| | - Óscar Lorenzo
- Department of Medicine, Autónoma University, 28049 Madrid, Spain; (Ó.L.); (J.L.M.-V.); (J.E.)
- Laboratory of Vascular Pathology, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz, 28040 Madrid, Spain;
| | - José Luis Martín-Ventura
- Department of Medicine, Autónoma University, 28049 Madrid, Spain; (Ó.L.); (J.L.M.-V.); (J.E.)
- Laboratory of Vascular Pathology, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz, 28040 Madrid, Spain;
- Centro de Investigación Biomédica en Red (CiberCV), 28029 Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
| | - Luis Blanco-Colio
- Laboratory of Vascular Pathology, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz, 28040 Madrid, Spain;
- Centro de Investigación Biomédica en Red (CiberCV), 28029 Madrid, Spain
| | | | | | - Rocío Carda
- Department of Cardiology, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz, 28040 Madrid, Spain; (A.M.P.-L.); (Á.A.); (R.C.); (J.T.)
- Department of Medicine, Autónoma University, 28049 Madrid, Spain; (Ó.L.); (J.L.M.-V.); (J.E.)
| | | | - Jesús Egido
- Department of Medicine, Autónoma University, 28049 Madrid, Spain; (Ó.L.); (J.L.M.-V.); (J.E.)
- Laboratory of Vascular Pathology, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz, 28040 Madrid, Spain;
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
- Department of Nephrology, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz, 28040 Madrid, Spain
| | - José Tuñón
- Department of Cardiology, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz, 28040 Madrid, Spain; (A.M.P.-L.); (Á.A.); (R.C.); (J.T.)
- Department of Medicine, Autónoma University, 28049 Madrid, Spain; (Ó.L.); (J.L.M.-V.); (J.E.)
- Laboratory of Vascular Pathology, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz, 28040 Madrid, Spain;
- Centro de Investigación Biomédica en Red (CiberCV), 28029 Madrid, Spain
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Dastgir N, Masood A, Muqeet A, Khan Niazi GZ. Frequency of risk factors in patients of acute coronary syndrome due to coronary ectasia. Asian Cardiovasc Thorac Ann 2020; 28:312-315. [PMID: 32551839 DOI: 10.1177/0218492320937155] [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] [Indexed: 11/16/2022]
Abstract
BACKGROUND Coronary artery ectasia is a relatively common entity characterized by inappropriate dilatation of the coronary vasculature. In some cases of acute coronary syndrome without obstructive coronary lesions, coronary ectasia is the sole cause. The exact mechanism of its development is unknown but evidence suggests a combination of genetic predisposition, common risk factors for coronary artery disease, and abnormal vessel wall metabolism. As there are few data regarding the pattern of coronary risk factors in patients with coronary ectasia, the objective of the study was to determine the frequency and distribution of coronary risk factors in patients with acute coronary syndrome solely due to coronary ectasia. METHODS The study included 155 patients over a period of 6 months, with coronary angiographic evidence of coronary ectasia as the sole cause of acute coronary syndrome. There were 79 (51%) men and 76 (49%) women with a mean age 51.92 ± 7.83 years; 73 (47.10%) were aged 20-50 years and 82 (52.90%) were 51-80 years of age. The frequencies of coronary risk factors were stratified according to sex and the two age groups. RESULTS Seventy-one patients (45.80%) had diabetes mellitus, 83 (53.54%) had hypertension, 55 (35.48%) were smokers, 46 (29.68%) had dyslipidemia, and 47 (30.3%) were obese. CONCLUSION Hypertension is the leading coronary risk factors in patients with acute coronary syndrome solely due to coronary ectasia, followed by diabetes mellitus and smoking.
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Affiliation(s)
- Noor Dastgir
- Department of Cardiology, Jinnah Hospital, Allama Iqbal Medical College, Lahore, Pakistan
| | - Arslan Masood
- Department of Cardiology, Jinnah Hospital, Allama Iqbal Medical College, Lahore, Pakistan
| | - Ahmed Muqeet
- Department of Cardiology, Jinnah Hospital, Allama Iqbal Medical College, Lahore, Pakistan
| | - Gul Zaman Khan Niazi
- Department of Cardiology, Chaudhary Pervaiz Ellahi Institute of Cardiology, Multan, Pakistan
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10
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Lu CH, Fang CW, Chen HM, Fang YP, Fang CT, Huang YB, Chen CY, Liao KM, Yeh SCJ. Prescribing patterns of coronary artery aneurysm in Taiwan. BMC Cardiovasc Disord 2019; 19:188. [PMID: 31382884 PMCID: PMC6683534 DOI: 10.1186/s12872-019-1172-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 07/26/2019] [Indexed: 01/25/2023] Open
Abstract
Background Coronary artery aneurysm (CAA) is a rare disease, and there are limited data on prescribing patterns for CAA. The aim of our study was to investigate prescribing patterns for CAA in Taiwan via the National Health Insurance Research Database (NHIRD). Methods We included all CAA patients in Taiwan from 2005 to 2011. Data from 1 year before and after the CAA diagnosis were used to analyze examinations, comorbidities and prescribing patterns. Results A total of 1397 patients diagnosed with CAA were enrolled in our study. Most pediatric patients with CAA were diagnosed with Kawasaki disease (95.7%). In pediatric CAA patients, the utilization rates of aspirin and gamma globulins were 82.9 and 53.6%, respectively, after CAA diagnosis. Among the antithrombotic agents, aspirin was used most commonly, followed by dipyridamole (16.9%), heparin (5.8%) and warfarin (4.6%). In adult CAA patients, common comorbidities included hypertension (63.4%), hyperlipidemia (39.6%), and diabetes mellitus (26.1%). Coronary atherosclerosis was identified in 72.5% of adult patients after CAA diagnosis. Antithrombotic agents, particularly aspirin, clopidogrel and heparin, were prescribed more frequently after CAA diagnosis. Among the prescribed medications, aspirin (75.8%), β-blockers (48.3%), statins (47.6%), metformin (14.4%), sulfonylureas (14.4%) and isosorbide mononitrate (32.9%) were frequently observed in each category. Conclusions Kawasaki disease was the main cause of CAA in pediatric patients, and coronary artery disease was the most common comorbidity in adult CAA patients. The most commonly used antithrombic agent after CAA diagnosis was aspirin in both adult and pediatric patients.
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Affiliation(s)
- Chun-Hui Lu
- Division of Pharmacy, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan
| | - Chih-Wun Fang
- Division of Pharmacy, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan
| | - Hao-Ming Chen
- Division of Pharmacy, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan.,Division of Health Technology Assessment, Center for Drug Evaluation, Taipei, Taiwan
| | - Yi-Ping Fang
- School of Pharmacy, Kaohsiung Medical University, 100, Shiquan 1st Rd., Sanmin Dist.,, Kaohsiung City, 80708, Taiwan, Republic of China
| | - Chein-Tang Fang
- School of Pharmacy, Kaohsiung Medical University, 100, Shiquan 1st Rd., Sanmin Dist.,, Kaohsiung City, 80708, Taiwan, Republic of China
| | - Yaw-Bin Huang
- School of Pharmacy, Kaohsiung Medical University, 100, Shiquan 1st Rd., Sanmin Dist.,, Kaohsiung City, 80708, Taiwan, Republic of China.,Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chung-Yu Chen
- School of Pharmacy, Kaohsiung Medical University, 100, Shiquan 1st Rd., Sanmin Dist.,, Kaohsiung City, 80708, Taiwan, Republic of China. .,Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. .,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
| | - Kuang-Ming Liao
- Department of Internal Medicine, Chi Mei Medical Center, Chiali, No.606, Jialixing, Jiali Dist., Tainan City, 72263, Taiwan, Republic of China.
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Schram HCF, Hemradj VV, Hermanides RS, Kedhi E, Ottervanger JP. Coronary artery ectasia, an independent predictor of no-reflow after primary PCI for ST-elevation myocardial infarction. Int J Cardiol 2018; 265:12-17. [PMID: 29731349 DOI: 10.1016/j.ijcard.2018.04.120] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 04/20/2018] [Accepted: 04/24/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND The no-reflow phenomenon is a serious complication after primary percutaneous coronary intervention (PCI) for ST-elevation Myocardial Infarction (STEMI). Coronary artery ectasia (CAE) may increase the risk of no-reflow, however, only limited data is available on the potential impact of CAE. The aim of this study was to determine the potential association between CAE and no-reflow after primary PCI. METHODS A case control study was performed based on a prospective cohort of STEMI patients from January 2000 to December 2011. All patients with TIMI 0-1 flow post primary PCI, in the absence of dissection, thrombus, spasm or high-grade residual stenosis, were considered as no-reflow case. Control subjects were two consecutive STEMI patients after each case, with TIMI flow ≥2 after primary PCI. CAE was defined as dilatation of an arterial segment to a diameter at least 1.5 times that of the adjacent normal coronary artery. RESULTS In the no-reflow group, frequency of CAE was significantly higher (33.8% vs 3.9%, p < 0.001) compared to the control group. Baseline variables were comparable between patients with and without CAE. Patients with CAE had more often TIMI 0-1 flow pre-PCI (91% vs 71% p = 0.03), less often anterior STEMI (3% vs 37%, p < 0.001) and underwent significantly less often a PCI with stenting (47% vs 74%, p = 0.003). After multivariate analysis, CAE remained a strong and independent predictor of no-reflow (OR 13.9, CI 4.7-41.2, p < 0.001). CONCLUSION CAE is a strong and independent predictor of no-reflow after primary PCI for STEMI. Future studies should assess optimal treatment.
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Affiliation(s)
| | | | | | - E Kedhi
- Isala, Zwolle, The Netherlands
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- Isala, Zwolle, The Netherlands
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12
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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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13
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Clinically Apparent Arterial Thrombosis in Persons with Systemic Vasculitis. Int J Rheumatol 2017; 2017:3572768. [PMID: 28713428 PMCID: PMC5497634 DOI: 10.1155/2017/3572768] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 02/14/2017] [Accepted: 03/07/2017] [Indexed: 11/22/2022] Open
Abstract
Objective To estimate the incidence rate of clinically apparent arterial thrombotic events and associated comorbidities in patients with primary systemic vasculitis. Methods Using large cohort administrative data from Quebec, Canada, we identified patients with vasculitis, including polyarteritis nodosa (PAN) and granulomatosis with polyangiitis (GPA). Incident acute myocardial infarctions (AMIs) and cerebrovascular accidents (CVAs) after the diagnosis of vasculitis were ascertained in the PAN and GPA group via billing and hospitalization data. These were compared to rates of a general population comparator group. The incidences of comorbidities (type 2 diabetes mellitus, dyslipidemia, and hypertension) were also collected. Results Among the 626 patients identified with vasculitis, 19.7% had PAN, 2.9% had Kawasaki disease, 23.8% had GPA, 52.4% had GCA, and 1.3% had Takayasu arteritis. The AMI rate was substantially higher in males aged 18–44 with PAN, with rates up to 268.1 events per 10,000 patient years [95% CI 67.1–1070.2], approximately 30 times that in the age- and sex-matched control group. The CVA rate was also substantially higher, particularly in adults aged 45–65. Patients with vasculitis had elevated incidences of diabetes, dyslipidemia, and hypertension versus the general population. Conclusion Atherothrombotic rates were elevated in patients identified as having primary systemic vasculitis. While incident rates of cardiovascular comorbidities were also increased, the substantial elevation in AMIs seen in young adults suggests a disease-specific component which requires further investigation.
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14
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Boles U, Pinto RC, David S, Abdullah AS, Henein MY. Dysregulated fatty acid metabolism in coronary ectasia: An extended lipidomic analysis. Int J Cardiol 2016; 228:303-308. [PMID: 27866019 DOI: 10.1016/j.ijcard.2016.11.093] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 11/06/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND Coronary artery ectasia (CAE) is not an uncommon clinical condition, which could be associated with adverse outcome. The exact pathophysiology of the disease is poorly understood and is commonly interpreted as a variant of atherosclerosis. In this study, we sought to undertake lipidomic profiling of a group of CAE patients in an attempt to achieve better understanding of its disturbed metabolism. METHODS Untargeted lipid profiling and complementary modelling strategies were employed to compare serum samples from 16 patients with CAE (mean age 63.5±10.1years, 6 female) and 26 controls with normal smooth coronary arteries (mean age 59.2±6.6years and 7 female). Sample preparation, LC-MS analysis and metabolite identification were performed at the Swedish Metabolomics Centre, Umeå, Sweden. RESULTS Phosphatidylcholine levels were significantly distorted in the CAE patients (p=0.001-0.04). Specifically, 16-carbon fatty acyl chain phosphatidylcholines (PC) were detected in lower levels. Similarly, 11 meioties of Sphyngomyelin (SM) species were detected at lower concentrations (p=0.000001-0.01) in the same group. However, only three metabolites were significantly higher in the pure CAE subgroup (6 patients) when compared with the 10 mixed CAE patients (two meioties of SM species and one of PC). Atherosclerosis risk factors were not different between groups. CONCLUSION This is the first lipid profiling study reported in coronary artery ectasia. While the lower concentration and dysregulation of sphyngomyelin suggests an evidence for premature apoptosis, that of phosphatidylcholines suggests perturbed fatty acid elongation/desaturation, thus may be indicative of non-atherogenic process in CAE.
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Affiliation(s)
- Usama Boles
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden; Cardiology Department, Letterkenny General Hospital, Co Donegal, Ireland
| | - Rui Climaco Pinto
- Computational Life Science Cluster (CLiC), Dept. of Chemistry, Umeå University, Sweden; Bioinformatics Infrastructure for Life Sciences (BILS), Sweden
| | - Santosh David
- Cardiology Department, Letterkenny General Hospital, Co Donegal, Ireland
| | | | - Michael Y Henein
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
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15
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Sen F, Yılmaz S, Kuyumcu MS, Ozeke O, Balcı MM, Aydoğdu S. The Presence of Fragmented QRS on 12-Lead Electrocardiography in Patients with Coronary Artery Ectasia. Korean Circ J 2014; 44:307-11. [PMID: 25278983 PMCID: PMC4180607 DOI: 10.4070/kcj.2014.44.5.307] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 07/15/2014] [Accepted: 08/04/2014] [Indexed: 01/14/2023] Open
Abstract
Background and Objectives Coronary artery ectasia (CAE) is an angiographic finding characterized by dilation of an arterial segment with a diameter at least 1.5 times that of its adjacent normal coronary artery. Fragmented QRS (fQRS) complexes are electrocardiographic signals which reflect altered ventricular conduction around regions of a myocardial scar and/or ischaemia. In the present study, we aimed to evaluate the presence of fQRS in patients with CAE. Subjects and Methods The study population included 100 patients with isolated CAE without coronary artery disease (CAD) and 80 angiographically normal controls. fQRS was defined as the presence of an additional R wave or notching of R or S wave or the presence of fragmentation in two contiguous leads corresponding to a major coronary artery territory. Results The two groups were similar in terms of age, sex, hypertension, dyslipidemia, and family history of CAD. The presence of fQRS was significantly (p<0.05) higher in the CAE group than that in the normal coronary artery group (29% vs. 6.2%, p=0.008). Isolated CAE were detected most commonly in the right coronary artery (61%), followed by left anterior descending artery (52%), left circumflex artery (36%), and left main artery (9%). Multivariate stepwise logistic regression analysis showed that CAE {odds ratio (OR) 1.412; 95% confidence interval (CI) 1.085-1.541; p=0.003} and diabetes (OR 1.310; 95% CI 1.025-1.482; p=0.041) were independently associated with fQRS. Conclusion The presence of fragmented QRS associated with increased risk for arrhythmias and cardiovascular mortality was significantly higher in patients with CAE than in patient with normal coronary artery. Further studies are needed to determine whether the presence of fragmented QRS is a possible new risk factor for patients with CAE.
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Affiliation(s)
- Fatih Sen
- Turkey Yuksek Ihtisas Education and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Samet Yılmaz
- Turkey Yuksek Ihtisas Education and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Mevlüt Serdar Kuyumcu
- Turkey Yuksek Ihtisas Education and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Ozcan Ozeke
- Turkey Yuksek Ihtisas Education and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Mustafa Mücahit Balcı
- Turkey Yuksek Ihtisas Education and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Sinan Aydoğdu
- Turkey Yuksek Ihtisas Education and Research Hospital, Cardiology Clinic, Ankara, Turkey
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16
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Huang QJ, Guo YL, Zhu CG, Qing P, Xu RX, Wu NQ, Jiang LX, Chen MH, Li JJ. Association of alkaline phosphatase with isolated coronary artery ectasia. Scandinavian Journal of Clinical and Laboratory Investigation 2014; 74:228-34. [PMID: 24564633 DOI: 10.3109/00365513.2013.878030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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17
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Yalcin AA, Topuz M, Akturk IF, Celik O, Erturk M, Uzun F, Duran M, Karadeniz M, Sarikamis C, Oner E. Is there a correlation between coronary artery ectasia and neutrophil-lymphocyte ratio? Clin Appl Thromb Hemost 2014; 21:229-34. [PMID: 24463600 DOI: 10.1177/1076029613520488] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
We aimed to investigate the association between the neutrophil-lymphocyte ratio (NLR) and coronary artery ectasia (CAE). The study included 198 patients who had undergone coronary angiography for suspected coronary artery disease (CAD). The patients were divided into the following 4 groups: group 1, 44 patients with normal coronary arteries; group 2, 61 patients with CAD; group 3, 40 patients with isolated CAE; and group 4, 53 patients with CAE coexisting with CAD. Neutrophil-lymphocyte ratio was significantly lower in group 1 than the other groups and significantly higher in group 4. Patients in group 1 had significantly lower neutrophil counts and significantly higher lymphocyte counts than the patients in group 4. The isolated CAE and CAD groups were similar in terms of NLR, neutrophil count, and lymphocyte count. In addition, we found significant positive correlations between presence of ectasia, number of ectatic vessels, and NLR. Our findings provide additional evidence for the role of NLR in CAE.
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Affiliation(s)
- Ahmet Arif Yalcin
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery, Training and Research Hospital, Istanbul, Turkey
| | - Mustafa Topuz
- Department of Cardiology, Turhal State Hospital, Turhal, Tokat, Turkey
| | - Ibrahim Faruk Akturk
- Department of Cardiology, 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
| | - Mehmet Erturk
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery, Training and Research Hospital, Istanbul, Turkey
| | - Fatih Uzun
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery, Training and Research Hospital, Istanbul, Turkey
| | - Mustafa Duran
- Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey
| | - Muhammed Karadeniz
- Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey
| | - Cetin Sarikamis
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery, Training and Research Hospital, Istanbul, Turkey
| | - Ender Oner
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery, Training and Research Hospital, Istanbul, Turkey
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Multi-level vascular aneurysms and polycystic kidney disease. Int J Cardiol 2014; 170:441-2. [DOI: 10.1016/j.ijcard.2013.11.061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2013] [Accepted: 11/23/2013] [Indexed: 11/23/2022]
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Bugan B, Onar LC. Is the Neutrophil-to-Lymphocyte Ratio a Crucial Indicator of Systemic Inflammation, Coronary Artery Ectasia, and Atherogenesis? Angiology 2013; 64:636. [DOI: 10.1177/0003319713491624] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Baris Bugan
- Malatya Military Hospital, Cardiology Service, Malatya, Turkey
| | - Lutfi Cagatay Onar
- Department of Cardiovascular Surgery, Maltepe University Faculty of Medicine, Istanbul, Turkey
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Sarli B, Baktir AO, Saglam H, Arinc H, Kurtul S, Sivgin S, Akpek M, Kaya MG. Neutrophil-to-lymphocyte ratio is associated with severity of coronary artery ectasia. Angiology 2013; 65:147-51. [PMID: 23657176 DOI: 10.1177/0003319713488932] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We investigated the association between coronary artery ectasia (CAE) and Neutrophil-to-lymphocyte ratio (NLR), an indicator of the inflammatory state. The study population included 434 patients (247 males, mean age 62 ± 10 years) including 230 patients with isolated CAE and 104 patients with coronary artery disease and 100 patientss with normal coronary arteries. The NLR was measured at admission and 30 days after coronary angiography in all the patients. The NLR was significantly higher in patients with CAE than those with normal coronary arteries (2.2 ± 0.6-1.3 ± 0.6, P < .001). Linear regression analyses revealed that NLR (coefficient β = -.61, P < .001) was significantly associated with severity of CAE. The NLR is significantly higher in patients with CAE compared to controls with normal coronary arteries, and NLR is associated with severity of CAE.
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Affiliation(s)
- Bahadir Sarli
- 1Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey
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21
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Yang JJ, Yang X, Chen ZY, Wang Q, He B, Du LS, Chen YD. Prevalence of coronary artery ectasia in older adults and the relationship with epicardial fat volume by cardiac computed tomography angiography. JOURNAL OF GERIATRIC CARDIOLOGY : JGC 2013; 10:10-5. [PMID: 23610568 PMCID: PMC3627703 DOI: 10.3969/j.issn.1671-5411.2013.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 01/31/2013] [Accepted: 02/27/2013] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Coronary artery ectasia (CAE) refers to abnormal dilation of coronary artery segments to 1.5 times of adjacent normal ones. Epicardial fat is associated with cardiovascular risk factors. The relationship between CAE and epicardial fat has not yet been investigated. This study aimed to assess the relationship between CAE and epicardial fat volume (EFV) in older people by dual-source computed tomography coronary angiography (CTCA). METHODS We prospectively enrolled 1400 older adults who were scheduled for dual-source CTCA. Under reconstruction protocols, patients with abnormal segments 1.5 times larger than the adjacent segments were accepted as CAE. EFV was measured by semi-automated software. Traditional risk factors in CAE patients, as well as the extent of EFV, were analyzed and compared to non-CAE group. RESULTS A total of 885 male and 515 female older patients were enrolled. CAE was identified by univariable analysis in 131 patients and significantly correlated to hypertension, smoking, hyperlipidemia, prior percutaneous coronary intervention and ascending aorta aneurysm. EFV was shown to be significantly higher in CAE patients than patients without ectasia. In multivariable analyses, EFV (P = 0.018), hypertension (P < 0.001) and hyperlipidemia (P < 0.001) were significantly correlated to CAE. There was a significant negative correlation between EFV and Markis classification. CONCLUSIONS CAE can be reliably recognized by dual-source CTCA. Epicardial fat might play a role in etiopathogenesis and progression of CAE, providing a new target for treating ectasia.
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Affiliation(s)
- Jun-Jie Yang
- Department of Cardiology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China
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Akyel A, Sahinarslan A, Kiziltunc E, Yıldız U, Alsancak Y, Akboga MK, Yayla C, Topal S, Bukan N, Ozdemir M. Neutrophil Gelatinase-Associated Lipocalin Levels in Isolated Coronary Artery Ectasia. Can J Cardiol 2011; 27:773-8. [DOI: 10.1016/j.cjca.2011.05.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2011] [Revised: 05/22/2011] [Accepted: 05/22/2011] [Indexed: 11/16/2022] Open
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Shabestari MM, Jabbari F, Gohari B, Moazen N, Azizi H, Moghiman T, Ibrahimzadeh S, Amirabadi A. Coronary artery angiographic changes in veterans poisoned by mustard gas. Cardiology 2011; 119:208-13. [PMID: 21985793 DOI: 10.1159/000331436] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Accepted: 07/27/2011] [Indexed: 11/19/2022]
Abstract
OBJECTIVES We aimed to identify coronary artery involvement in mustard gas-poisoned patients. METHODS We conducted a case-control study on 40 mustard gas-poisoned patients who underwent coronary artery angiography due to cardiac pain. The study was performed during a 3-year interval on patients who were referred to three main hospitals of Mashhad, Iran. The nonexposed control group consisted of 40 normal individuals who had undergone angiography for the same reasons. The primary outcome measurement was coronary artery involvement and its location. Data were collected through studying the angiography films. RESULTS Among the 40 poisoned patients studied, 15 (37.5%) had coronary artery ectasia, mainly in the left anterior descending artery, but 25 (62.5%) did not. The same values were 2 (5%) and 38 (95%) in the nonexposed group, respectively, which was significantly different compared to the exposed group (p = 0.001). The odds ratio was 11.40. CONCLUSIONS The prevalence of coronary artery ectasia in mustard gas-poisoned patients was 7.5 times more than in nonexposed controls. Considering the proposed odds ratio, the occurrence of coronary artery ectasia is around 11.4 times greater in mustard gas-poisoned veterans. This is the first study to suggest a strong correlation between mustard gas poisoning and coronary artery ectasia.
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Viktorsson TV, Arnorsson T, Sigurdsson MI, Sverrisson JT, Gudbjartsson T. A Giant Unruptured Aneurysm of the Sinus of Valsalva Together With Ectasia of the Left Coronary Artery. Ann Thorac Surg 2011; 92:354-6. [DOI: 10.1016/j.athoracsur.2011.01.043] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2010] [Revised: 01/09/2011] [Accepted: 01/18/2011] [Indexed: 11/25/2022]
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