Background: Coronary artery ectasia (CAE) is a rare form of aneurysmal coronary heart disease. This condition increases risk of ischemia that leaded to stable angina pectoris and also acute coronary syndrome. Objectiv...Background: Coronary artery ectasia (CAE) is a rare form of aneurysmal coronary heart disease. This condition increases risk of ischemia that leaded to stable angina pectoris and also acute coronary syndrome. Objective: To evaluate the incidence of CAE and to analyze clinical and angiographic characteristics among patients with symptomatic coronary artery disease. Methods: Retrospective trial of diagnostic coronary angiography which was performed at Alshifa hospital in Gaza, included all patients with coronary heart disease and underwent diagnostic coronary angiography from March 2014 to March 2023. We evaluate the incidence, clinical presentation and angiographic findings of patients with symptomatic coronary ectasia. Results: Of the 12,534 angiograms analyzed, CAE was found in 539 patients, an incidence of 4.3%. The mean age was 59.2 ± 11.7 years, and male gender predominate 81.8%. A 285 (52.9%) of patients found to have single ectatic vessel at their angiographic results. In two vessels 120 patients (22.3%), in three vessels 95 patients (17.6%) and in three vessel plus left main in 39 patients (7.2%). 70.9% angiograms showed pure ectasia without associated significant stenotic lesions in the same vessel. The right coronary artery (RCA) was the commonest affected vessel by ectasia. The most common presentation of patients is non ST segment elevation acute coronary syndrome. Conclusion: The incidence of coronary ectasia was 4.3%. Non ST segment elevation acute coronary syndrome was the most common clinical presenting. Only 30% of patients have additionally significant coronary artery stenosis. The majority of patients had single vessel involvement and right coronary artery was the most common involved vessel. Despite a dapper understanding of CAE in last years, there are still come critical issues about optimal treatment. Large multicenter randomized control trials are recommended to guide the clinician in the management of this complex sitting of patients.展开更多
目的本研究拟对合并糖尿病的UA或NSTEMI的患者使用FFR导丝指导PCI术的获益情况进行分析。方法 80例合并糖尿病的UA或NSTEMI患者随机分配至FFR和单纯血管造影组,分别比较PCI手术治疗情况(包括手术时间、适合植入支架的病灶数、植入支架...目的本研究拟对合并糖尿病的UA或NSTEMI的患者使用FFR导丝指导PCI术的获益情况进行分析。方法 80例合并糖尿病的UA或NSTEMI患者随机分配至FFR和单纯血管造影组,分别比较PCI手术治疗情况(包括手术时间、适合植入支架的病灶数、植入支架数量、糖蛋白IIb/IIIa受体拮抗剂使用率和住院时间)和随访1年后的心血管不良反应事件。结果 FFR导丝指导PCI组患者手术时间较血管造影组少3分钟,但无统计学差异(62±31 vs 65±23,p=0.703),适合植入支架的病灶数较少(2.3±0.8 vs 2.7±0.7,p=0.024)、植入支架少(1.9±1.1 vs 2.5±1.3,P<0.01)、糖蛋白IIb/IIIa受体拮抗剂使用率减少(45%vs 55%,p=0.03)、住院时间缩短(4.8±2.5 vs 5.9±2.2,p=0.012)。术后随访1年,FFR组和血管造影组不良反应事件无明显差异:FFR组患者因各种原因进行再次PCI以及冠脉搭桥术比例(13%vs 15%,p=0.675)、发生心肌梗死的比例(5%vs 10%,p=0.071)以及心绞痛发作的比例(30%vs 38%,p=0.064)均较血管造影组要少,但均无显著差异。心功能评级无显著差异。结论 FFR指导合并糖尿病的UA或NSTEMI患者进行PCI成本效益明显优于仅根据血管造影结果指导PCI。展开更多
文摘Background: Coronary artery ectasia (CAE) is a rare form of aneurysmal coronary heart disease. This condition increases risk of ischemia that leaded to stable angina pectoris and also acute coronary syndrome. Objective: To evaluate the incidence of CAE and to analyze clinical and angiographic characteristics among patients with symptomatic coronary artery disease. Methods: Retrospective trial of diagnostic coronary angiography which was performed at Alshifa hospital in Gaza, included all patients with coronary heart disease and underwent diagnostic coronary angiography from March 2014 to March 2023. We evaluate the incidence, clinical presentation and angiographic findings of patients with symptomatic coronary ectasia. Results: Of the 12,534 angiograms analyzed, CAE was found in 539 patients, an incidence of 4.3%. The mean age was 59.2 ± 11.7 years, and male gender predominate 81.8%. A 285 (52.9%) of patients found to have single ectatic vessel at their angiographic results. In two vessels 120 patients (22.3%), in three vessels 95 patients (17.6%) and in three vessel plus left main in 39 patients (7.2%). 70.9% angiograms showed pure ectasia without associated significant stenotic lesions in the same vessel. The right coronary artery (RCA) was the commonest affected vessel by ectasia. The most common presentation of patients is non ST segment elevation acute coronary syndrome. Conclusion: The incidence of coronary ectasia was 4.3%. Non ST segment elevation acute coronary syndrome was the most common clinical presenting. Only 30% of patients have additionally significant coronary artery stenosis. The majority of patients had single vessel involvement and right coronary artery was the most common involved vessel. Despite a dapper understanding of CAE in last years, there are still come critical issues about optimal treatment. Large multicenter randomized control trials are recommended to guide the clinician in the management of this complex sitting of patients.
文摘目的本研究拟对合并糖尿病的UA或NSTEMI的患者使用FFR导丝指导PCI术的获益情况进行分析。方法 80例合并糖尿病的UA或NSTEMI患者随机分配至FFR和单纯血管造影组,分别比较PCI手术治疗情况(包括手术时间、适合植入支架的病灶数、植入支架数量、糖蛋白IIb/IIIa受体拮抗剂使用率和住院时间)和随访1年后的心血管不良反应事件。结果 FFR导丝指导PCI组患者手术时间较血管造影组少3分钟,但无统计学差异(62±31 vs 65±23,p=0.703),适合植入支架的病灶数较少(2.3±0.8 vs 2.7±0.7,p=0.024)、植入支架少(1.9±1.1 vs 2.5±1.3,P<0.01)、糖蛋白IIb/IIIa受体拮抗剂使用率减少(45%vs 55%,p=0.03)、住院时间缩短(4.8±2.5 vs 5.9±2.2,p=0.012)。术后随访1年,FFR组和血管造影组不良反应事件无明显差异:FFR组患者因各种原因进行再次PCI以及冠脉搭桥术比例(13%vs 15%,p=0.675)、发生心肌梗死的比例(5%vs 10%,p=0.071)以及心绞痛发作的比例(30%vs 38%,p=0.064)均较血管造影组要少,但均无显著差异。心功能评级无显著差异。结论 FFR指导合并糖尿病的UA或NSTEMI患者进行PCI成本效益明显优于仅根据血管造影结果指导PCI。
