Coronary Artery Ectasia in Ischemic Heart Disease Patients Referred to aTertiary Cardiac Center

Abstract

ABSTRACT:BACKGROUND:Coronary artery ectasia represents a form of atherosclerotic coronary artery disease seen in 1-5% of patients undergoing coronary angiography.OBJECTIVE:This study was conducted to verify the clinical characteristics and angiographic patterns of patients with coronary artery ectasia (CAE) among ischemic heart disease patients.METHODS:Coronary artery ectasia was identified in 62 patients by using coronary angiography. Patients were divided into 2 groups: Group A, included patients with isolated CAE (CAE and non flow limiting narrowing < 50%). Group B, included 51 patients with coexistence CAE with obstructive coronary artery disease (CAE and >70% narrowing of coronary artery). Then we compared these two groups with a control group (group C) which included patients with obstructive coronary artery disease in absence of CAE.RESULTS:In the study, 122 were analyzed; the mean age of patients was 56.1 ± 9.6 years. There were 99 (81.1%) males and 23 (18.9%) females. There were no significant differences regarding (age, hypertension, smoking, diabetes mellitus, body mass index and family history of ischemic heart disease) among three groups, but there was significant difference regarding gender in which males constituted (54.5%), (90.2%), (78.3%) of patients in group A, group B and group C respectively.There was significant difference in mode of presentation among these groups in which typical ischemic chest pain was found in (27.3%), (72.5%), (83.3%) of patients in group A, group B and group C respectively. Also there was significant difference in the electrocardiographic changes in which the changes were found in (45.5%), (84.4%), (58.6%) of patients in group A, group B and group C respectively.In patients with isolated CAE, right coronary artery was most frequently involved (91%) and by diffuse type of ectasia (50%) while in patients with coexistence of CAE and obstructive coronary artery disease, the left anterior descending artery was most frequently involved (72.5%) and by focal type of ectasia (45%).CONCLUSION:Male gender was more prevalent in patients with obstructive coronary artery disease than patients with isolated CAE. Also typical ischemic and electrocardiographic changes of myocardial ischemia were more prevalent in patients with obstructive coronary artery disease.