Liang Siwen, Zhang Yue, Gao Xiangyu, Zhao Huiqiang, Di Beibing, Sheng Qianqian, Liu Ruifeng
1 Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Angiology. 2019 Jan;70(1):62-68. doi: 10.1177/0003319718782807. Epub 2018 Jun 21.
Coronary artery ectasia (CAE) is a rare disease and a substantial portion of patients with CAE are first diagnosed with acute myocardial infarction (AMI). The question was raised if CAE was a kind of thrombotic disease. We assessed a consecutive series of 119 patients with CAE including 32 patients with AMI (CAE + AMI group) and 87 patients without AMI (CAE group). During the same period, 90 patients with coronary heart disease, 90 patients with normal coronary arteries (control), and 120 AMI patients without CAE (AMI group) were randomly selected and evaluated. Both current and previous AMI prevalence rates in the CAE population were higher than the AMI rate for the other patients undergoing coronary angiograms; the mean platelet volume and fibrinogen were increased in the CAE + AMI and CAE groups. For patients with CAE with AMI, most of the thrombotic lesions were in the ectasia site. After dividing the patients with CAE into with and without antiplatelet treatment groups before admission, the AMI rate was lower in the antiplatelet group. Platelets may participate in the thrombotic process in CAE. Antiplatelet treatment may decrease the AMI rate of patients with CAE.
冠状动脉扩张（CAE）是一种罕见疾病，相当一部分CAE患者最初被诊断为急性心肌梗死（AMI）。有人提出疑问，CAE是否为一种血栓形成性疾病。我们评估了连续的119例CAE患者，包括32例AMI患者（CAE + AMI组）和87例无AMI患者（CAE组）。同期，随机选取并评估了90例冠心病患者、90例冠状动脉正常患者（对照组）和120例无CAE的AMI患者（AMI组）。CAE人群中当前和既往AMI患病率均高于其他接受冠状动脉造影的患者的AMI发生率；CAE + AMI组和CAE组的平均血小板体积和纤维蛋白原升高。对于伴有AMI的CAE患者，大多数血栓形成病变位于扩张部位。将入院前CAE患者分为抗血小板治疗组和未抗血小板治疗组后，抗血小板组的AMI发生率较低。血小板可能参与了CAE的血栓形成过程。抗血小板治疗可能降低CAE患者的AMI发生率。
