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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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Soltani D, Jafari S, Ashraf H, Sobh-Rakhshankhah A, Kolahchi Z, Masoudkabir F, Boroumand MA, Vasheghani-Farahani A. Ratio of Serum Aspartate to Alanine Aminotransferase as a Marker of Isolated Coronary Artery Ectasia and its Severity. Heart Int 2020; 14:43-48. [PMID: 36277666 PMCID: PMC9524754 DOI: 10.17925/hi.2020.14.1.43] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 04/27/2020] [Indexed: 04/24/2024] Open
Abstract
BACKGROUND Several studies have reported an association between elevated liver enzymes and increased risks for developing inflammatory diseases. The aim of our study was to examine how serum liver transaminases, as inexpensive and routinely measured markers, and the De Ritis ratio are associated with the presence of coronary artery ectasia (CAE) and its severity. METHODS Participants were recruited from patients admitted to Tehran Heart Center for diagnostic coronary angiography due to suspected myocardial ischaemia. These participants also underwent concurrent laboratory routine biochemical and liver enzyme tests. RESULTS A total of 104 participants were included; 59 had CAE and 45 were controls without coronary artery disease (CAD). The CAE group was split into a further two subgroups: those with isolated CAE (n=27) and those with CAD and coexisting CAE (n=32). In the adjusted multivariate analysis, a lower ratio of aspartate aminotransferase to ALT (AST/ALT) was, uniquely among the variables, a statistically significant marker for isolated CAE. In the CAD + CAE group, the AST/ALT ratio was not significant after adjustments for the confounding factors. The multivariate linear regression for the Markis score showed that the AST/ALT ratio was inversely associated with the severity of CAE. CONCLUSIONS We conclude that the AST/ALT ratio and, to some extent, ALT independently of other inflammatory factors, can be associated with the presence and severity of isolated CAE.
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Affiliation(s)
- Danesh Soltani
- Students’ Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Samira Jafari
- Students’ Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Haleh Ashraf
- Cardiac Primary Prevention Research Center (CPPRC), Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Cardiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Sobh-Rakhshankhah
- Cardiac Primary Prevention Research Center (CPPRC), Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Kolahchi
- Students’ Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Farzad Masoudkabir
- Cardiac Primary Prevention Research Center (CPPRC), Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Boroumand
- Department of Pathology and Laboratory Medicine, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Vasheghani-Farahani
- Cardiac Primary Prevention Research Center (CPPRC), Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
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Endo H, Dohi T, Dohi S, Wada H, Doi S, Kato Y, Okai I, Iwata H, Okazaki S, Isoda K, Yamamoto T, Miyauchi K, Amano A, Daida H. Clinical indicators and coronary angiographic features of expansive arterial remodelling in patients with abdominal aortic aneurysms. PLoS One 2019; 14:e0219730. [PMID: 31310617 PMCID: PMC6634394 DOI: 10.1371/journal.pone.0219730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 07/01/2019] [Indexed: 12/13/2022] Open
Abstract
The co-existence of expansive arterial remodelling in both coronary arteries (CAs) and the abdominal aorta has already been reported, although the clinical indicators and quantitative analysis have not been well studied. We therefore aimed to clarify the clinical and anatomical characteristics of patients with abdominal aortic aneurysms (AAAs). 123 AAA patients who underwent coronary angiography were compared to 123 control patients selected by propensity score matching. CA diameters of all 3 vessels were measured by quantitative coronary angiographic analysis. Coronary artery ectasia (CAE) was defined as local or generalized aneurysmal change of the CAs. Excessive expansive CA remodelling was defined as the maximal diameter of the right or left circumflex artery in the upper 75th percentile (>4.8 mm). Multivariable logistic regression analyses were used to determine predictors of CAE and excessive expansive CA remodelling. The prevalences of CAE and excessive expansive CA remodelling were significantly higher in the AAA group than in the non-AAA group (28% vs. 8% and 31% vs. 19%; both p<0.05). On multivariable analysis, the presence of AAA (odds ratio (OR), 4.56; 95% confidence intervals (95%CI) 2.18-10.4) and body mass index (BMI) (OR, 1.11; 95%CI 1.03-1.21) were independently associated with CAE, and higher high-sensitivity C-reactive protein (OR, 2.19; 95%CI 1.08-4.52) and BMI (OR, 1.11; 95%CI 1.02-1.21) were independently associated with excessive expansive CA remodelling. In conclusions, this study showed a higher prevalence of ectatic CA disease in AAA patients and suggests that higher inflammation and obesity are associated with expansive arterial remodelling in coronary arteries.
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Affiliation(s)
- Hirohisa Endo
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Tomotaka Dohi
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
- * E-mail:
| | - Shizuyuki Dohi
- Department of Cardiovascular Surgery, Juntendo University Graduate School of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Hideki Wada
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Shinichiro Doi
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Yoshiteru Kato
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Iwao Okai
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Hiroshi Iwata
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Shinya Okazaki
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Kikuo Isoda
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Taira Yamamoto
- Department of Cardiovascular Surgery, Juntendo University Graduate School of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Katsumi Miyauchi
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Atsushi Amano
- Department of Cardiovascular Surgery, Juntendo University Graduate School of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Hiroyuki Daida
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
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Fang CT, Fang YP, Huang YB, Kuo CC, Chen CY. Epidemiology and risk factors of coronary artery aneurysm in Taiwan: a population based case control study. BMJ Open 2017; 7:e014424. [PMID: 28667203 PMCID: PMC5734584 DOI: 10.1136/bmjopen-2016-014424] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES Coronary artery aneurysm (CAA) is usually an asymptomatic and rare disease. There are limited epidemiological data for CAA in Asian populations and in the rest of the world. DESIGN A retrospective case control study. SETTING A population based, database study from Taiwan's National Health Insurance Research Database, between 2005 and 2011. PARTICIPANTS CAA patients identified using International Classification of Diseases, ninth revision, clinical modification (ICD-9-CM) code 414.11 with CAA examinations. OUTCOME MEASURES The incidence rate and mortality rate of CAA were calculated. We also matched patients with non-CAA patients according to age, gender and index year at a 1:10 ratio to explore the risk factors for CAA using conditional logistic regression. RESULT A total of 1397 CAA patients were identified between 2005 and 2011; 41.9% were paediatric patients and 58.1% were adults. The incidence rate and mortality rate of CAA in Taiwan were 0.87 and 0.05 per 105 person-years, respectively. The adjusted odds ratios (aOR) for coronary atherosclerosis, hypertension, dyslipidaemia and diabetes were 7.97, 2.09, 2.48 and 1.51, respectively. Of note, aortic dissection (aOR 6.76), aortic aneurysm (aOR 5.82) and systemic lupus erythematosus (aOR 4.09) were found to be significantly associated with CAA. CONCLUSION In Taiwan, CAA patients were distributed across both paediatric and adult populations. Apart from cardiovascular risk factors, aortic diseases and systemic lupus erythematosus need to be investigated further in CAA patients.
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Affiliation(s)
- Chein-Tang Fang
- School of Pharmacy, Master Program in Clinical Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Ping Fang
- School of Pharmacy, Master Program in Clinical Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yaw-Bin Huang
- School of Pharmacy, Master Program in Clinical Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chen-Chun Kuo
- Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chung-Yu Chen
- School of Pharmacy, Master Program in Clinical Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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Fariba F, Moradi M, Arabi A, Ghaderi B. Prevalence of Coronary Artery Ectasia with Atherosclerosis and Associated Risk Factors in the West of Iran: A Cross-Sectional Study. J Res Health Sci 2016; 16:22-5. [PMID: 27061992 PMCID: PMC7189084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2015] [Revised: 01/18/2016] [Accepted: 03/07/2016] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND According to the angiographic findings, 3%-8% of atherosclerotic coronary artery patients suffer from coronary artery ectasia (CAE). We conducted this study to estimate the prevalence of CAE among patients who underwent angiography and compared this group with those patients without CAE and atherosclerosis in terms of common coronary heart disease (CHD) risk factors. METHODS This cross sectional study was conducted in Hamadan Province, western Iran, from March 2014 to March 2015. Data were collected from angiography evaluation and clinical records in Ekbatan Hospital. The patients with atherosclerosis who had CAE were compared with patients who had neither CAE nor atherosclerosis. The categorical variables were compared using chi-squared test or Fisher's exact test. RESULTS Of 2767 patients who underwent coronary angiography, 166 (6.0%) had CAE with atherosclerosis, 2357 (85.2%) had atherosclerosis without CAE, and 244 (8.8%) had normal coronary artery. Compared to normal group, CAE patient were more hypertensive and smoker. Besides, in CAE group the proportion of dyslipidemia was higher than normal subject. CONCLUSIONS The prevalence of CAE in Hamadan Province was in the expected level. Distribution of common CHD risk factors were most prevalent in CAE patient in comparison with normal coronary artery group.
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Affiliation(s)
- Farnaz Fariba
- Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Mehdi Moradi
- Department of Cardiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Arezzo Arabi
- Clinical Research Development Unit of Farshchian Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Behzad Ghaderi
- Department of Cardiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
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