Núñez-Gil Iván J, Nombela-Franco Luis, Bagur Rodrigo, Bollati Mario, Cerrato Enrico, Alfonso Emilio, Liebetrau Christoph, De la Torre Hernandez José María, Camacho Benjamín, Mila Rafael, Amat-Santos Ignacio J, Alfonso Fernando, Rodríguez-Olivares Ramón, Camacho Freire Santiago J, Lozano Íñigo, Jiménez Díaz Víctor Alfonso, Piraino Davide, Latini Roberto Adriano, Feltes Gisela, Linares Jose Antonio, Mancone Massimo, Ielasi Alfonso, Sánchez-Grande Flecha Alejandro, Fernández Cisnal Agustín, Ugo Fabrizio, Jiménez Mazuecos Jesús M, Omedè Pierluigi, Pavani Marco, Villablanca Pedro A, Louka Boshra F, Fernández-Ortiz Antonio
Cardiovascular Institute, Hospital Clínico San Carlos and Department of Medicine, Complutense University, Madrid, Spain.
Division of Cardiology, Department of Medicine, London Health Sciences Centre, and Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada.
Clin Cardiol. 2017 Aug;40(8):580-585. doi: 10.1002/clc.22705. Epub 2017 Mar 24.
Coronary artery aneurysm is defined as a coronary dilation that exceeds the diameter of adjacent segments or the diameter of the patient's largest normal coronary vessel by 1.5×. It is an uncommon disease that has been diagnosed with increasing frequency since the widespread appearance of coronary angiography. The published incidence varies from 1.5% to 5%, suggesting male dominance and a predilection for the right coronary artery. Although several causes have been described, atherosclerosis accounts for ≥50% of coronary aneurysms in adults. Reported complications include thrombosis and distal embolization, rupture, and vasospasm, causing ischemia, heart failure, or arrhythmias. The natural history and prognosis remain unknown, as definitive data are scarce. Controversies persist regarding the use of medical management (antithrombotic therapy) or interventional/surgical procedures. Only some case reports or small case series are available about this condition. The Coronary Artery Aneurysm Registry (CAAR; http://www.ClinicalTrials.gov NCT02563626) is a multicenter international ambispective registry that aims to provide insights on anatomic, epidemiologic, and clinical aspects of this substantially unknown entity. In addition, the registry will assess management strategies (conservative, interventional, or surgical) and their short- and long-term results in a large cohort of patients.
ClinicalTrials.gov. Unique identifier: NCT02563626.
冠状动脉瘤被定义为冠状动脉扩张，其直径超过相邻节段直径或患者最大正常冠状动脉血管直径的1.5倍。这是一种罕见疾病，自冠状动脉造影广泛应用以来，其诊断频率不断增加。已发表的发病率在1.5%至5%之间，提示男性居多且右冠状动脉更易受累。尽管已描述了多种病因，但动脉粥样硬化在成人冠状动脉瘤中占比≥50%。报道的并发症包括血栓形成和远端栓塞、破裂以及血管痉挛，可导致缺血、心力衰竭或心律失常。由于确切数据稀缺，其自然病史和预后仍不明确。关于药物治疗（抗血栓治疗）或介入/手术治疗的应用仍存在争议。关于这种情况仅有一些病例报告或小病例系列。冠状动脉瘤登记处（CAAR；http://www.ClinicalTrials.gov NCT02563626）是一个多中心国际前瞻性登记处，旨在提供关于这个基本上未知实体的解剖、流行病学和临床方面的见解。此外，该登记处将在大量患者队列中评估管理策略（保守、介入或手术）及其短期和长期结果。
ClinicalTrials.gov。唯一标识符：NCT02563626。
