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      Association between Traditional Risk Factors and Coronary Artery Ectasia: A Study on 10057 Angiographic Procedures among Iranian Population

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          Abstract

          Background: Whether coronary artery ectasia (CAE) is a unique clinical finding or results from other clinical entities is still unknown. We aimed to determine the CAE prevalence, investigate the relationship between CAE and patients’ demographic and clinical characteristics, and assess the prognosis at follow-up in a sample of Iranian population.

          Methods: Totally, 10057 patients who underwent coronary angiography were divided into three categories: normal coronary arteries without co-existing coronary artery disease; CAE without co-existing coronary artery narrowing < 50%; and coronary artery stenosis with > 50% luminal narrowing (CAS).

          Results: The prevalence of CAE was 1.5%. Compared to the normal individuals, the CAE patients were older, were more frequently male, and had higher rates of myocardial infarction (MI). The CAE patients had a lower frequency of diabetes and MI than the CAS group. The CAE patients were largely focused between 40 to 60 years of age. The right coronary and left anterior descending arteries were the most involved arteries, and ectasia was located more frequently in the proximal part of these arteries. Patients with ectasia in the three main vessels had higher rates of MI. After a mean follow-up of 54.23 ± 18.41 months, chest pain and dyspnea on exertion remained the main complaint in more than 97% of the patients, leading to hospital admission in more than 14%.

          Conclusion: There was no relationship between the presence of ectasia and conventional risk factors. According to our study, pure CAE may be deemed a benign feature of atherosclerosis; however, it can lead to frequent hospital admissions because of the persistence of cardiovascular symptoms.

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          Most cited references23

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          Clinical significance of coronary arterial ectasia.

          In a study group of 2,457 consecutive patients undergoing cardiac catheterization, 30 patients had coronary arterial ectasia, an irregular dilatation of major vessels up to seven times the diameter of branch vessels. The frequency of hypertension, abnormal electrocardiogram and history of myocardial infarction was greater than that in a control group with obstructive coronary artery disease. Patients with ectasia did not differ from patients with obstructive disease in sex, age, prevalence of angina or presence of metabolic abnormalities. Six deaths occurred in the group with ectasia during a mean follow-up period of 24 months (annual rate of 15 percent). Extensive destruction of the musculoelastic elements was evident, resulting in marked attenuation of the vessel wall. The short-term prognosis in this group is the same as in medically treated patients with three vessel obstructive coronary artery disease.
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            Coronary artery ectasia. Its prevalence and clinical significance in 4993 patients.

            To assess the clinical significance of coronary artery ectasia 4993 consecutive coronary arteriograms were reviewed to identify patients with this condition and to allow the assessment of their progress. Coronary ectasia was a relatively uncommon finding (overall incidence 1.4%). It was not related to the development of aortic aneurysms and did not affect the outcome, results of coronary artery surgery, or symptoms.
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              Aneurysmal coronary artery disease.

              To examine the clinical and historical features and the natural history of aneurysmal coronary disease, we reviewed the registry data of the Coronary Artery Surgery Study (CASS). Nine hundred seventy-eight patients, representing 4.9% of the total registry population, were identified as having aneurysmal disease. No significant differences were noted between aneurysmal and nonaneurysmal coronary disease patients when features such as hypertension, diabetes, lipid abnormalities, family history, cigarette consumption, incidence of documented myocardial infarction, presence and severity of angina, and presence of peripheral vascular disease were examined. In addition, no difference in 5-year medical survival was noted between these two groups. These findings suggest that aneurysmal coronary disease does not represent a distinct clinical entity but is, rather, a variant of coronary atherosclerosis.
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                Author and article information

                Journal
                J Tehran Heart Cent
                J Tehran Heart Cent
                JTHC
                The Journal of Tehran University Heart Center
                Tehran University of Medical Sciences, 2006- (Tehran, Iran )
                1735-5370
                2008-2371
                12 January 2014
                : 9
                : 1
                : 27-32
                Affiliations
                [1] Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
                Author notes
                [* ]Corresponding Author: Mani Khorsand Askari, Cardiologist, Tehran University of Medical Sciences, Tehran Heart Center, North Kargar Street, Tehran, Iran. 1411713138. Tel: +98 21 88029257. Fax: +98 21 88029256 khorsandmani@ 123456yahoo.com
                Article
                JTHC-9-27
                4277788
                25561967
                2eccad3e-16d4-483c-a41b-f29073466c5d
                Copyright © Tehran Heart Center, Tehran University of Medical Sciences

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, ( http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 5 February 2013
                : 11 July 2013
                Categories
                Original Article

                Cardiovascular Medicine
                coronary angiography • coronary vessel anomalies • prevalence • risk factors

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