"Coronary Ectasia in Patients Undergoing Coronary Angiography at a Tertiary Care Center: Prevalence and Prognostic Implications"

Abstract

Coronary artery ectasia (CAE) is characterized by abnormal expansion of coronary arteries, with variable clinical manifestations. This study investigates the prevalence, clinical profiles, risk factors, and angiographic features of CAE, as well as its impact on coronary blood flow and prognosis in patients with coronary artery disease.

A prospective, observational study was conducted in tertiary hospital over two years (April 2021 to April 2023). The study consisted of 60 consecutive patients undergoing coronary angiography, with a focus on age, gender, comorbidities, and risk factors. The Markis classification system was used to categorize CAE patterns. The study also examined the relationship between diabetes, inflammation, dyslipidemia, homocysteine levels, vitamin D deficiency, and CAE. Long-term outcomes and the impact of CAE on coronary blood flow were assessed.

Results: The study found a male predominance in the CAE population, with an average age of 56.62 years. Diabetes and smoking were identified as risk factors associated with CAE, and ST-segment elevation myocardial infarction was the most common presentation. The Markis type 4 pattern was most frequently observed, with the right coronary artery being the most affected. Diabetic patients with CAE had distinct ectatic segments. Inflammation, neutrophil : lymphocyte ratio, C-reactive protein, dyslipidemia, elevated LDL-C, serum homocysteine levels, and vitamin D deficiency were all linked to CAE. Slow blood flow and alterations in blood flow patterns were observed in patients with ectatic coronary arteries. Mortality rates in CAE patients were similar to those with coronary artery disease without ectasia.

Conclusion: CAE is associated with various clinical and biochemical factors, impacting coronary blood flow. A better understanding of these associations can guide clinical management decisions in patients with CAE.