Clinical characteristics and efficiency of interventional therapy for coronary artery involvement in Takayasu's arteritis

Abstract

To explore the clinical characteristics and efficacies of interventional therapy for coronary artery involvement in Takayasu's arteritis (TA). A total of 98 consecutive hospitalized TA patients with more than 50% diameter reduction of coronary artery by angiography were retrospectively analyzed from 2000 to 2013 at Peking Union Medical College Hospital. Six cases (6/98, 6.1%) had coronary artery involvement of TA. All were females with an age range of 15-51 (32 ± 16) years. The manifestations included typical angina pectoris with a depression of ST segment on electrocardiogram. Among them, myocardial enzyme elevated in 5 cases and fulfilled the diagnosis of non-ST elevated myocardial infarction.Four cases had peripheral arterial involvement while another 2 cases had only coronary involvement. Coronary angiography was useful for definitive diagnosis. Coronary ostia was the most frequently involved.Five patients received successful coronary revascularization with drug-eluting stent and the symptom of angina pectoris improved.However, 1 patient developed restenosis in stent 3 months after percutaneous coronary intervention (PCI). Coronary artery involvement in TA is not rare, especially ostia. The patients usually present with non-ST elevated myocardial infarction. PCI with drug-eluting stent may improve the symptoms, but the long-term effect should be investigated further.