Coronary artery ectasia and markers of atherosclerosis
IJCCR
Characteristics of coronary artery ectasia and its
association with carotid intima-media thickness and
high sensitivity C-reactive protein
Osama Sanad
1
, Eman Al-Keshk
2
, Ahmed Ramzy
3
, Mohammed A.Tabl
4
, Ahmed Bendary
5
1,2,3,4,5
Cardiology department, Benha university hospital, Benha faculty of medicine, Egypt.
This study was conducted to uncover the relation between coronary artery ectasia (CAE) and
markers of atherosclerosis. A total of 1611 coronary angiograms were prospectively examined
to find out patients with CAE. Those patients were divided into 2 groups: Mixed CAE with
stenotic coronary artery disease (CAD) “group 1” and pure CAE “group 2”. Two control groups
of age-adjusted subjects were selected consecutively in a 1:1 fashion; one with normal
coronaries “group 3” (Pure CAE: normal coronaries) and the other with obstructive CAD only
“group 4” (Mixed CAE: obstructive CAD). All recruited subjects underwent carotid intima-media
thickness (IMT) and high sensitivity C-reactive protein (hs-CRP) level measurements. Out of
examined angiograms, 35 subjects showed mixed CAE “group 1” and 26 showed pure CAE
“group 2”. Age and gender-adjusted logistic regression analysis model revealed that significant
independent predictors for CAE were: hypertension, smoking, absence of DM and hs-CRP level
> 3 mg/L. Mean carotid IMT was significantly higher in group 2 than group 3 and in group 4 than
group 1 (1±0.1 versus 0.4±0.2 mm and 1.4±0.4 versus 1±0.2 mm respectively, P < 0.001 for both).
Mean hs-CRP level was significantly higher in group 1 than group 4 and in group 2 than group 3
(7±2 versus 3±0.8 mg/L and 6±2 versus 1±0.6 mg/L respectively, P < 0.001 for both). We
concluded that atherosclerosis may not be the only plausible explanation for CAE.
Keywords: Coronary artery ectasia; Carotid intima-media thickness; high sensitivity C-reactive protein; Atherosclerosis.
INTRODUCTION
Coronary artery ectasia (CAE), sometimes known as
„dilated coronopathy‟, is relatively uncommon
angiographic finding (Lam and Ho, 2004). This condition
is diagnosed if the diameter of a dilated segment of an
artery is 1.5 times greater than the diameter of the
adjacent normal segments of the artery (Hartnell et al,
1985). Markis et al, 1976 introduced the following
classification of CAE based on the extent of coronary
affection: type I, diffuse ectasia of two or three vessels;
type II, diffuse disease in one vessel and localized
disease in another one; type III, diffuse ectasia of one
vessel only; and type IV, localized or segmental ectasia.
Coronary angiography remains the main diagnostic tool
for CAE (Mavrogeni, 2010).The clinical presentation and
the long-term cardiac complications have long been
thought to be associated with the severity of the co-
existing obstructive coronary lesion, despite the fact that
„pure‟ coronary ectasia (without obstructive coronary
lesions) can be implicated in angina or myocardial
infarction (Demopoulos et al, 1997).
*Corresponding author: Ahmed Bendary Msc, Cardiology
department, Benha university hospital, Benha faculty of
medicine, Egypt, Postal code no. 13518. E-mail:
dr_a_bendary@hotmail.com, Cellular: 01220778216, Tel.:
002013319014
Coauthors: osamasanad@hotmail.com
1
,
emansaeed6767@yahoo.com
2
, aramzy1977@yahoo.com
3
,
mshafytabl@yahoo.com
4
International Journal of Cardiology and Cardiovascular Research
Vol. 3(1), pp. 024-030, June, 2016. © www.premierpublishers.org. ISSN: 2146-3133
Research Article