Coronary Artery Ectasia as a Histopathological Pattern of Atherosclerosis

Abstract

We read with interest the letter by Erayman and Sen regarding our article entitled ‘‘Association Between Coronary Artery Ectasia and Neutrophil-Lymphocyte Ratio.’’ The etiopathogenesis of coronary artery ectasia (CAE) is not very well defined. The CAE shares some features with atherosclerosis. First, CAE and coronary artery disease (CAD) have similar risk factors. Second, the 2 conditions exhibit similar histopathological features. A recent study has shown that the carotid–intima media thickness (cIMT) is a marker of atherosclerotic disease and also indicates an increased risk of the progression of atherosclerosis in patients with CAE. Additionally, a study evaluated plasma C-reactive protein (CRP) levels in patients with isolated CAE. The CRP levels were found to be significantly higher in patients with isolated CAE. In this context, we considered that because some indicators (eg, cIMT and CRP) had been evaluated previously, we should evaluate a novel, simple, and inexpensive inflammatory marker to compare with all of the inflammatory markers, especially expensive indicators. The neutrophil–lymphocyte (N/L) ratio has received increased attention due to its role as an inflammatory marker for many conditions. For this reason, because N/L ratio may be affected by many conditions, we also assessed the mean platelet volume (MPV) together with N/L ratio, because the MPV is another, easy, inexpensive inflammatory marker. Many routine laboratory tests such as red cell distribution width, platelet distribution width, eosinophil count, platelet/lymphocyte ratio, total bilirubin, uric acid, g-glutamyl transferase, and N-terminal pro-B-type natriuretic peptide levels are simple, relatively inexpensive, and markers to evaluate and stratify patients with CAE.