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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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Bahremand M, Zereshki E, Matin BK, Rezaei M, Omrani H. Hypertension and coronary artery ectasia: a systematic review and meta-analysis study. Clin Hypertens 2021; 27:14. [PMID: 34261539 PMCID: PMC8281588 DOI: 10.1186/s40885-021-00170-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 06/02/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Coronary artery ectasia (CAE) is characterized by the enlargement of a coronary artery to 1.5 times or more than other non-ectasia parts of the vessel. It is important to investigate the association of different factors and CAE because there are controversial results between available studies. We perform this systematic review and meta-analysis to evaluate the effects of hypertension (HTN) on CAE. METHODS To find the potentially relevant records, the electronic databases, including Scopus, PubMed, and Science Direct were searched on 25 July 2019 by two of the authors independently. In the present study, the pooled odds ratio (OR) accompanied by 95 % confidence intervals (CIs) were calculated by a random-effects model. Heterogeneity presented with the I2 index. Subgroup analysis and sensitivity analysis by the Jackknife approach was performed. RESULTS Forty studies with 3,263 cases and 7,784 controls that investigated the association between HTN and CAE were included. The pooled unadjusted OR of CAE in subjects with HTN in comparison by subjects without HTN was estimated 1.44 (95 % CI, 1.24 to 1.68) with moderate heterogeneity (I2 = 41 %, Cochran's Q P = 0.004). There was no evidence of publication bias in the analysis of HTN and CAE with Egger's test (P = 0.171), Begg's test (P = 0.179). Nine articles reported the adjusted effect of HTN on CAE by 624 cases and 628 controls. The findings indicated the overall adjusted OR was 1.03 (95 % CI, 0.80 to 1.25) with high heterogeneity (I2 = 58.5 %, Cochran's Q P = 0.013). CONCLUSIONS We found that when the vessel was in normal condition, HTN was not very effective in increasing the chance of CAE and only increased the CAE chance by 3 %. This is an important issue and a warning to people who have multiple risk factors together. More studies need to be performed to further establish these associations by reported adjusted effects.
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Affiliation(s)
- Mostafa Bahremand
- Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ehsan Zereshki
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Behzad Karami Matin
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mansour Rezaei
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hamidreza Omrani
- Imam Reza Hospital Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Ziaee M, Mashayekhi S, Ghaffari S, Mahmoudi J, Sarbakhsh P, Garjani A. Predictive Value of Endocan Based on TIMI Risk Score on Major Adverse Cardiovascular Events After Acute Coronary Syndrome. Angiology 2018; 70:952-959. [DOI: 10.1177/0003319718815241] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
We assessed the prognostic value of serum levels of endocan in patients with the acute coronary syndrome (ACS) through its correlation with the Thrombolysis in Myocardial Infarction (TIMI) risk score and compared the possible association with clinical outcomes. In this prospective cross-sectional study, we enrolled 320 patients with documented ST-segment elevation myocardial infarction (STEMI), non-STEMI (NSTEMI), or unstable angina (UA) who underwent diagnostic coronary angiography. Endocan was measured soon after admission in the emergency department. In-hospital death, heart failure, and recurrent infarction were considered major adverse cardiac events (MACEs). There was a significant positive correlation between endocan level and TIMI risk score and MACE. The optimal cutoff values of endocan to predict clinical end points were 3.45 ng/mL in patients with STEMI and 2.85 ng/mL in patients with UA/NSTEMI. Multivariate logistic regression analysis indicated that endocan independently correlated with MACE. Moreover, cardiac troponin I, creatine kinase-MB, and circulating endocan were found to be independently associated with MACE in patients with ACS. In conclusion, a high endocan level on hospital admission is an independent predictor of worse cardiovascular outcomes and higher TIMI risk score in patients with ACS.
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Affiliation(s)
- Mojtaba Ziaee
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sina Mashayekhi
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Samad Ghaffari
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Javad Mahmoudi
- Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parvin Sarbakhsh
- Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Garjani
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Pharmacology, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
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