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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 subj...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Tehran University of Medical Sciences
2020
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8217191/ https://www.ncbi.nlm.nih.gov/pubmed/34178086 http://dx.doi.org/10.18502/jthc.v15i4.5943 |
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author | 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 |
author_facet | 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 |
author_sort | Amirzadegan, Alireza |
collection | PubMed |
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. |
format | Online Article Text |
id | pubmed-8217191 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Tehran University of Medical Sciences |
record_format | MEDLINE/PubMed |
spelling | pubmed-82171912021-06-25 One-Year Outcome of Patients with Coronary Artery Ectasia Undergoing Percutaneous Coronary Intervention: Clinical Implications and Question Marks 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 J Tehran Heart Cent Original Article 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. Tehran University of Medical Sciences 2020-10 /pmc/articles/PMC8217191/ /pubmed/34178086 http://dx.doi.org/10.18502/jthc.v15i4.5943 Text en Copyright © 2020 Tehran University of Medical Sciences. https://creativecommons.org/licenses/by-nc/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International license (https://creativecommons.org/licenses/by-nc/4.0/). Non-commercial uses of the work are permitted, provided the original work is properly cited. |
spellingShingle | Original Article 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 One-Year Outcome of Patients with Coronary Artery Ectasia Undergoing Percutaneous Coronary Intervention: Clinical Implications and Question Marks |
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 | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8217191/ https://www.ncbi.nlm.nih.gov/pubmed/34178086 http://dx.doi.org/10.18502/jthc.v15i4.5943 |
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