One-Year Outcome of Patients with Coronary Artery Ectasia Undergoing Percutaneous Coronary Intervention: Clinical Implications and Question Marks
Background: Coronary artery ectasia (CAE) is a rare condition with unclear pathophysiology, optimal treatment, and prognosis. We aimed to determine the prognostic implications of CAE following coronary angioplasty. Methods: We conducted a retrospective cohort study on 385 patients, including 87 s...
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| Format: | Article |
| Language: | English |
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Tehran University of Medical Sciences
2020-10-01
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| Series: | Journal of Tehran University Heart Center |
| Subjects: | |
| Online Access: | https://jthc.tums.ac.ir/index.php/jthc/article/view/1255 |
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| author | Alireza Amirzadegan Seyed-Ali Sadre-Bafghi Saeed Ghodsi Hamidreza Soleimani Mehrnaz Mohebi Ebrahim Nematipour Ali-Mohammad Haji-Zeinali Mojtaba Salarifar Hamidreza Pourhosseini Yones Nozari Masih Tajdini Hassan Aghajani Mohammad Alidoosti Yaser Jenab Negar Omidi Arash Jalali Zahra Hosseini |
| author_facet | Alireza Amirzadegan Seyed-Ali Sadre-Bafghi Saeed Ghodsi Hamidreza Soleimani Mehrnaz Mohebi Ebrahim Nematipour Ali-Mohammad Haji-Zeinali Mojtaba Salarifar Hamidreza Pourhosseini Yones Nozari Masih Tajdini Hassan Aghajani Mohammad Alidoosti Yaser Jenab Negar Omidi Arash Jalali Zahra Hosseini |
| author_sort | Alireza Amirzadegan |
| collection | DOAJ |
| description | Background: Coronary artery ectasia (CAE) is a rare condition with unclear pathophysiology, optimal treatment, and prognosis. We aimed to determine the prognostic implications of CAE following coronary angioplasty.
Methods: We conducted a retrospective cohort study on 385 patients, including 87 subjects with CAE, who underwent percutaneous coronary intervention (PCI). Major adverse cardiovascular events (MACE) were considered to consist of mortality, nonfatal myocardial infarction (MI), repeated revascularization, and stroke.
Results: The mean age of the participants was 57.31±6.70 years. Multivariate regression analysis revealed that patients with diabetes, ST-segment–elevation MI at presentation, and high thrombus grades were more likely to have suboptimal post-PCI thrombolysis in myocardial infarction (TIMI) flow. However, CAE was not a predictor of a decreased TIMI flow (OR: 1.46, 95% CI: 0.78–8.32; P=0.391). The Cox-regression model showed that CAE, the body mass index, and a family history of MI were risk factors for MACE, while short lesion lengths (<20 vs >20 mm) had an inverse relationship. The adjusted hazard ratio (HR) for the prediction of MACE in the presence of CAE was 1.65 (95% CI: 1.08–4.78; P=0.391). All-cause mortality (HR: 1.69, 95% CI: 0.12–3.81; P=0.830) and nonfatal MI (HR: 1.03, 95% CI: 0.72–4.21; P=0.341) occurred similarly in the CAE and non-CAE groups. Conversely, CAE increased urgent repeat revascularization (HR: 2.40; 95% CI: 1.13–5.86; P=0.013).
Conclusion: Although CAE had no substantial short-term prognostic effects on post-PCI TIMI flow, considerable concerns regarding adverse outcomes emerged during our extended follow-up. Stringent follow-ups of these patients should be underscored due to the high likelihood of urgent revascularization. |
| first_indexed | 2024-12-24T04:05:24Z |
| format | Article |
| id | doaj.art-0f2bc088ec7a4eea8f6f12ef687fb189 |
| institution | Directory Open Access Journal |
| issn | 1735-8620 2008-2371 |
| language | English |
| last_indexed | 2024-12-24T04:05:24Z |
| publishDate | 2020-10-01 |
| publisher | Tehran University of Medical Sciences |
| record_format | Article |
| series | Journal of Tehran University Heart Center |
| spelling | doaj.art-0f2bc088ec7a4eea8f6f12ef687fb1892022-12-21T17:16:12ZengTehran University of Medical SciencesJournal of Tehran University Heart Center1735-86202008-23712020-10-0115410.18502/jthc.v15i4.5943One-Year Outcome of Patients with Coronary Artery Ectasia Undergoing Percutaneous Coronary Intervention: Clinical Implications and Question MarksAlireza Amirzadegan0Seyed-Ali Sadre-Bafghi1Saeed Ghodsi2Hamidreza Soleimani3Mehrnaz Mohebi4Ebrahim Nematipour5Ali-Mohammad Haji-Zeinali6Mojtaba Salarifar7Hamidreza Pourhosseini8Yones Nozari9Masih Tajdini10Hassan Aghajani11Mohammad Alidoosti12Yaser Jenab13Negar Omidi14Arash Jalali15Zahra Hosseini16Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Department of Cardiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.Background: Coronary artery ectasia (CAE) is a rare condition with unclear pathophysiology, optimal treatment, and prognosis. We aimed to determine the prognostic implications of CAE following coronary angioplasty. Methods: We conducted a retrospective cohort study on 385 patients, including 87 subjects with CAE, who underwent percutaneous coronary intervention (PCI). Major adverse cardiovascular events (MACE) were considered to consist of mortality, nonfatal myocardial infarction (MI), repeated revascularization, and stroke. Results: The mean age of the participants was 57.31±6.70 years. Multivariate regression analysis revealed that patients with diabetes, ST-segment–elevation MI at presentation, and high thrombus grades were more likely to have suboptimal post-PCI thrombolysis in myocardial infarction (TIMI) flow. However, CAE was not a predictor of a decreased TIMI flow (OR: 1.46, 95% CI: 0.78–8.32; P=0.391). The Cox-regression model showed that CAE, the body mass index, and a family history of MI were risk factors for MACE, while short lesion lengths (<20 vs >20 mm) had an inverse relationship. The adjusted hazard ratio (HR) for the prediction of MACE in the presence of CAE was 1.65 (95% CI: 1.08–4.78; P=0.391). All-cause mortality (HR: 1.69, 95% CI: 0.12–3.81; P=0.830) and nonfatal MI (HR: 1.03, 95% CI: 0.72–4.21; P=0.341) occurred similarly in the CAE and non-CAE groups. Conversely, CAE increased urgent repeat revascularization (HR: 2.40; 95% CI: 1.13–5.86; P=0.013). Conclusion: Although CAE had no substantial short-term prognostic effects on post-PCI TIMI flow, considerable concerns regarding adverse outcomes emerged during our extended follow-up. Stringent follow-ups of these patients should be underscored due to the high likelihood of urgent revascularization.https://jthc.tums.ac.ir/index.php/jthc/article/view/1255Coronary artery diseasePercutaneous coronary interventionDilatation; pathologicMortalityPrognosis |
| spellingShingle | Alireza Amirzadegan Seyed-Ali Sadre-Bafghi Saeed Ghodsi Hamidreza Soleimani Mehrnaz Mohebi Ebrahim Nematipour Ali-Mohammad Haji-Zeinali Mojtaba Salarifar Hamidreza Pourhosseini Yones Nozari Masih Tajdini Hassan Aghajani Mohammad Alidoosti Yaser Jenab Negar Omidi Arash Jalali Zahra Hosseini One-Year Outcome of Patients with Coronary Artery Ectasia Undergoing Percutaneous Coronary Intervention: Clinical Implications and Question Marks Journal of Tehran University Heart Center Coronary artery disease Percutaneous coronary intervention Dilatation; pathologic Mortality Prognosis |
| title | One-Year Outcome of Patients with Coronary Artery Ectasia Undergoing Percutaneous Coronary Intervention: Clinical Implications and Question Marks |
| title_full | One-Year Outcome of Patients with Coronary Artery Ectasia Undergoing Percutaneous Coronary Intervention: Clinical Implications and Question Marks |
| title_fullStr | One-Year Outcome of Patients with Coronary Artery Ectasia Undergoing Percutaneous Coronary Intervention: Clinical Implications and Question Marks |
| title_full_unstemmed | One-Year Outcome of Patients with Coronary Artery Ectasia Undergoing Percutaneous Coronary Intervention: Clinical Implications and Question Marks |
| title_short | One-Year Outcome of Patients with Coronary Artery Ectasia Undergoing Percutaneous Coronary Intervention: Clinical Implications and Question Marks |
| title_sort | one year outcome of patients with coronary artery ectasia undergoing percutaneous coronary intervention clinical implications and question marks |
| topic | Coronary artery disease Percutaneous coronary intervention Dilatation; pathologic Mortality Prognosis |
| url | https://jthc.tums.ac.ir/index.php/jthc/article/view/1255 |
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