Risk factors and outcomes in patients with ectatic infarct‐related artery who underwent primary percutaneous coronary intervention after ST elevated myocardial infarction

Abstract

We aimed to assess the risk factors for coronary artery ectasia (CAE) as infarct-related artery (IRA) and short-term and 1year outcomes. CAE in patients with ST elevated myocardial infarction (STEMI) is a rare condition with a limited knowledge about the risk factors associated with coronary artery ectasia in STEMI and prognosis after primary percutaneous coronary interventions. Retrospectively, 1655 patients with STEMI who were undergone coronary angiography were included in this study. Patients were divided into two groups according to their coronary anatomy as ectasia and control groups. Demographic features, angiographic results, and clinical events were compared. Multivariate analysis was performed to assess the association of the features with CAE in STEMI. In total, 1655 patients (99 patients in CAE group vs 1556 patients in control group) were analyzed. Hypertension and smoking were significantly higher in CAE group. No-reflow rates were significantly higher (13.1% vs 5.4%, p = 0.004) in CAE group. In-hospital mortality rates were similar between the groups. Difference in revascularization rates (8.1% vs 9.6%, p = 0.39) and death in 1year (6.1% vs 4.9%, p = 0.37) were also nonsignificant between the groups. According to results of the multivariate analysis, hypertension (Odds ratio (OR): 1.71 (1.14-2.58), p = 0.01) and smoking (OR: 1.98 (1.32-2.99), p = 0.001) remained significantly associated with coronary ectasia. In conclusion, despite being higher no-reflow rates, short-term and 1year survival and revascularization rates were similar between the groups. Additionally, hypertension and smoking were associated with CAE as IRA. © 2016 Wiley Periodicals, Inc.