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- Title
One-Year Outcome of Patients with Coronary Artery Ectasia Undergoing Percutaneous Coronary Intervention: Clinical Implications and Question Marks.
- Authors
Amirzadegan, Alireza; Sadre-Bafghi, Seyed-Ali; Ghodsi, Saeed; Soleimani, Hamidreza; Mohebi, Mehrnaz; Nematipour, Ebrahim; Haji-Zeinali, Ali-Mohammad; Salarifar, Mojtaba; Pourhosseini, Hamidreza; Nozari, Yones; Tajdini, Masih; Aghajani, Hassan; Alidoosti, Mohammad; Jenab, Yaser; Omidi, Negar; Jalali, Arash; Hosseini, Zahra
- Abstract
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(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.
- Subjects
SURGICAL complication risk factors; CARDIOVASCULAR diseases risk factors; PERCUTANEOUS coronary intervention; TRANSLUMINAL angioplasty; ACQUISITION of data methodology; CONFIDENCE intervals; STROKE; MULTIPLE regression analysis; CORONARY disease; RETROSPECTIVE studies; SURGERY; PATIENTS; MYOCARDIAL infarction; TREATMENT effectiveness; RISK assessment; MYOCARDIAL revascularization; MEDICAL records; DESCRIPTIVE statistics; REOPERATION; ODDS ratio; BODY mass index; LONGITUDINAL method; PROPORTIONAL hazards models; FAMILY history (Medicine); EVALUATION
- Publication
Journal of Tehran University Heart Center, 2020, Vol 15, Issue 4, p177
- ISSN
1735-8620
- Publication type
Article