Noninvasive assessment of coronary artery ectasia using multidetector computed tomography.

OBJECTIVES

The aim of this study is to determine the prevalence of coronary artery ectasia and its relationship to atheromatous changes in participants undergoing coronary computed tomography angiography.

BACKGROUND

Coronary artery ectasia occasionally encountered on conventional coronary angiography is considered a manifestation of atherosclerosis.

METHODS

Four hundred consecutive participants, 300 men (mean age 56 years) who underwent coronary computed tomography angiography were evaluated. Coronary artery ectasia was defined as an arterial segment with a diameter of at least 1.5 times the diameter of the adjacent normal coronary artery. The prevalence and location of coronary artery ectasia as well as concomitant atherosclerotic changes were evaluated. The association of coronary artery ectasia with coronary risk factors was also studied.

RESULTS

Coronary artery ectasia was encountered in 31 participants (8%), 29 men. The right coronary artery was most commonly affected with ectasia (50%) and most participants had single-vessel involvement (74%). Twenty-six of 31 participants (84%) had coexisting atheromatous wall changes or insignificant coronary artery disease; four participants out of 31 (13%) had significant coronary artery disease. Coronary artery ectasia thrombosis was found only in one patient (3%). No apparent correlation was present between coronary artery ectasia and diabetes mellitus, hypertension, hyperlipidemia, smoking and family history of coronary artery disease.

CONCLUSION

The prevalence of coronary artery ectasia in consecutive participants who underwent coronary computed tomography angiography is 8%. The right coronary artery was most commonly affected and most participants had single-vessel involvement. Coronary artery ectasia usually is associated with atheromatous changes, but not with significant coronary artery disease. Coronary artery ectasia thrombosis was a rare complication. No specific predisposing factors have been identified.