Clinical expression of coronary artery ectasia.

OBJECTIVE

Coronary artery ectasia (CAE) is an uncommon finding at cardiac catheterisation. Our objective was to retrospectively assess the angiographic prevalence of CAE and its clinical expression.

METHODS

From January 1999 to June 2001, 3870 consecutive patients underwent coronary angiography at our catheterisation laboratory.

RESULTS

The prevalence of CAE was 3.6%. Most patients were male (89.2%). Type 1 CAE was observed in 20% of patients, type 2 in 11%, type 3 in 43%, and type 4 in 26%. The right coronary artery was most commonly involved (75%). In 55 patients with acute myocardial infarction, CAE within the culprit vessel was found in 32 patients (58.1%): ectasia was associated with stenosis in 29 patients, whereas isolated CAE was observed in only three patients. In 23 patients (41.8%), CAE was detected as a collateral finding in the presence of the culprit occluded, non-ectatic vessel. Overall, in the 109 patients (78%) with acute coronary syndrome, the culprit lesion was found to be related to the ectatic vessel in 46 patients (33.1%): ectasia was associated with stenosis in 39 patients, whereas isolated CAE was observed in only seven patients. In 66.9% CAE was an incidental finding on angiography. At follow-up, three patients with CAE died (2%).

CONCLUSIONS

In our investigation, the angiographic prevalence of CAE was 3.6%. CAE occurred predominantly in males and more often affected the right coronary artery. It was associated with acute coronary syndrome in one third of cases. Isolated CAE was associated with a good prognosis at follow-up.