Coronary Ectasia Research Articles

Risk Factors for Intravenous Immunoglobulin Non-responsiveness and Coronary Ectasia in Korean Patients With Kawasaki Disease.

We aimed to determine the risk factors for non-responsiveness to intravenous immunoglobulin (IVIG) and coronary ectasia in Korean children with Kawasaki disease (KD) and compare the efficacy of previously published Japanese and Chinese risk scoring systems in the same cohort. We retrospectively reviewed 459 KD cases diagnosed from January 1, 2013, to December 31, 2022. Age (odds ratio [OR]: 0.983; 95% confidence interval [CI]: 0.968-0.999), change in extremities (OR: 3.308; 95% CI: 1.530-7.151), neutrophils (OR: 1.078; 95% CI: 1.049-1.108), and alanine aminotransferase (OR: 1.002; 95% CI: 1.000-1.004) were identified as independent risk factors for IVIG non-responsiveness, and age (OR: 0.945; 95% CI: 0.902-0.989), C-reactive protein (OR: 1.092; 95% CI: 1.004-1.188), and creatinine kinase (OR: 1.004; 95% CI: 1.001-1.006) were identified as independent risk factors for coronary ectasia. Among previously published risk scoring systems, the Egami (area under the receiver operating characteristics curve [AUC]: 0.695; 95% CI: 0.651-0.737) for IVIG non-responsiveness and the Tang score (AUC: 0.726; 95% CI: 0.578-0.874) for coronary ectasia showed the highest predictive value for our study cohort.

The Association between Visfatin as A Marker of Isolated Coronary Ectasia and Its Severity: A Cross-Sectional study

Abstract Aim and objectives to assess the association between Visfatin level-as an independent marker -and the presence of coronary artery ectasia in patients undergoing diagnostic coronary angiography. Patients and Methods A total of 90 participants were recruited from candidates undergoing diagnostic coronary angiography in the Cath lab of Cardiology Department at Ain Shams University. They were then divided into three groups. The first group included individuals with normal coronaries, the second patients with coronary artery disease (CAD) without ectasia, and the third is patients with isolated coronary artery ectasia (CAE). After history taking, they all underwent biochemical tests for serum Visfatin, HBA1C%, serum creatinine and CRP. Univariate and correlation analysis was done. Results regarding demographic and clinical characteristics of our study population, we found that only higher age and being a smoker was significantly associated with the presence of ectasia. High level of serum Visfatin was strongly significantly associated with the presence of ectasia. Serum creatinine and CRP displayed a similar pattern. Moreover, we found that the mean level of serum Visfatin increases with the severity of ectasia according to Markis classification. Finally, Roc showed that a cut- off value of > 34 ng/ml demonstrated a sensitivity of 89% and a specificity of 87% of predicting CAE. Conclusion high serum Visfatin level is significantly associated with the presence of coronary artery ectasia. Also, it is positively correlated with its severity according to Markis classification. Hence, it can be a valuable predictor of CAE.

CORONARY ARTERY ANEURYSM IN IGG4–RELATED DISEASE

Abstract Introduction Coronary artery ectasia is a rare disease defined as a local or diffuse dilatation of the coronary artery more than 1.5 times the diameter of the adiacent normal segment. The etiology is diverse and can be rarely associated with immunoglobulin G4 (IgG4)–related disease. The high levels of serum IgG4 may promote the development of low–density plaques, intimal thickening due to pericoronitis and subsequent coronary ectasia. Case Report We present the case of a 72–year–old male patient with arterial hypertension, dyslipidemia, chronic renal insufficiency, and a family history of cardiovascular diseases. In the previous year, he suffered a cerebral hemorrhage attributed to an unspecified cerebral vascular malformation, which was managed with an endovascular approach. The patient was admitted for Non–ST–segment Elevation Myocardial Infarction (NSTEMI). Coronary angiography revealed widespread ectasia of the coronary vessels, a chronically occluded marginal branch, and an aneurysmatic proximal right coronary artery with the presence of a thrombus on the aneurysmal segment, dissolved following administration of intracoronaric heparin. Furthermore a critical stenosis at the crux involving the posterior interventricular branch was detected and angioplasty with drug–eluting stent implantation was performed on the affected vessel. Given the coronary artery ectasia, aortic ectasia revealed by echocardiography, renal insufficiency and persistently elevated amylase and lipase levels, further diagnostic investigation was conducted suspecting IgG4–related disease. Hematological tests revealed elevated IgG and IgG4 subclass levels (882 mg/dL and 1438 mg/L, respectively), C3 117 mg/dL, C4 30 mg/dL, and total IgE 130 KU/L. The diagnosis of IgG4–related disease was confirmed and the patient was advised to continue cardiological and rheumatological follow–up. Conclusion When the coronary arteries are involved in the IgG4–related disease, risk of acute events such as heart attack may increase and the prognosis is poor. Coronary thickening and ectasia, typical imaging features, other aortic involvement and inflammation indicators, like elevated serum IgG4, should be considered as red flags for an early investigation and subsequent early intervention.

Post-infarction ventricular septal defect associated with coronary ectasia. Case report

Post-infarction ventricular septal defect associated with coronary ectasia. Case report

Pattern of Coronary Angiography in Young Adults versus Older Adults Presented by Coronary Artery Disease in Correlation to Their Risk Factors with 1-year Follow-up of Their Clinical Outcome

Abstract Background: Coronary artery disease (CAD) is a leading cause of mortality worldwide, with varying patterns and risk factors across different age groups. While CAD is common in older adults, data on young adults are limited, with traditional risk factors and familial history playing a significant role in early disease development. The purpose of this study was to compare the coronary angiographic patterns in young adults (<40 years) and older adults (≥40 years) presented with CAD, assess the correlation with risk factors, and monitor clinical outcomes after 1 year. Patients and Methods: This retrospective cohort study was conducted at the National Heart Institute, including 2204 consecutive patients undergoing coronary angiography and/or percutaneous coronary intervention for CAD from January 2019 to January 2020. Patients were divided into two groups based on age: group A (<40 years) and Group B (≥40 years). Angiographic findings, risk factors, and clinical outcomes were assessed and compared. Results: Group B had significantly higher rates of hypertension (63.6% vs. 22.2%, P < 0.001), diabetes (53.5% vs. 24.1%, P < 0.001), and female gender (29% vs. 11.1%, P < 0.001) compared to Group A. Group A showed higher smoking rates (70.4% vs. 46.5%, P < 0.001) and positive family history (42.6% vs. 4.4%, P < 0.001). Angiographic findings revealed higher rates of single-vessel affection, coronary ectasia, aneurysm, and slow flow phenomenon in Group A, whereas Group B demonstrated more bifurcation lesions, chronic total occlusion, and calcification. Conclusions: This study highlights the need for age-specific approaches in managing CAD, with younger patients showing early disease onset and older patients exhibiting more complex disease. Tailored cardiovascular care is essential, focusing on lifestyle modifications in younger adults and managing metabolic conditions in older adults.

MINOCA and Coronary Ectasia: a rare combination of causes of infarction

to describe a patient with myocardial ischemia with multiple causes. This clinical case describes a 58-year-old man with a history of hypertension, dyslipidemia, COPD and previous myocardial infarction (AMI). He went to the emergency room with chest pain and dyspnea. Findings included bibasal crackles, electrocardiogram with old anterior fibrosis, elevated NT-ProBNP, and echocardiogram with septoapical akinesia. During hospitalization, he experienced tachyarrhythmia and hemodynamic deterioration, undergoing electrical cardioversion (CVE). Non-ST segment elevation acute coronary syndrome (NSTEACS) complicated with ventricular arrhythmia and acute pulmonary edema was diagnosed. Coronary angiography revealed coronary ectasias without obstructive lesions, but with mild stenosis in three vessels. The patient was successfully treated with non-invasive ventilation, diuretics, vasodilators and anticoagulation. The discharge was granted with the plan to further studies to optimize and guide treatment and finally the diagnosis of Myocardial Infarction with Non-Obstructive Arteries (MINOCA) and the presence of coronary ectasias was addressed. it is important to highlight the non-ischemic causes in MINOCA and the association between coronary ectasia and cardiovascular events, which is why we emphasize the need for more studies to better understand the relationship between these phenomena.

Kawasaki Disease: Unveiling the Complexities of an Enigmatic Pediatric Vasculitis

Kawasaki disease is a critical vasculitis of childhood that principally affects the coronary arteries. The main causeof Kawasaki disease leftovers unidentified, even if an infectious agent is sturdily suspected based on clinical andepidemiologic features. A genetic predilection is also likely, based on fluctuating incidences among ethnic groups,with advanced rates in Asians. Symptoms contain fever, conjunctival injection, erythema of the lips and oralmucosa, rash, and cervical lymphadenopathy. Some children with Kawasaki disease progress coronary arteryaneurysms or ectasia, ischemic heart disease, and unexpected death. Kawasaki disease is the foremost cause ofacquired heart disease among children in technologically advanced countries. This article offers a summary of theanalytic and treatment guidelines published by the AHA.

Unusual Occurrence: Primary Aldosteronism Leading to Unique Coronary Ectasia

Unusual Occurrence: Primary Aldosteronism Leading to Unique Coronary Ectasia

Percutaneous Coronary Intervention in Patients with Coronary Artery Ectasia: A Retrospective Single-center Study.

This retrospective single-center study aimed to compare the outcomes of ad-hoc versus planned percutaneous coronary intervention (PCI) in patients with coronary ectasia. We investigated baseline characteristics, primary and secondary outcomes, and predictors of mortality in a cohort of patients who underwent PCI procedures. Data from 3,179 patients (ad-hoc PCI, n = 1,286; planned PCI, n = 1,893) with coronary ectasia were analyzed. Baseline characteristics, including age, gender, comorbidities, and lesion characteristics, were compared between the two groups. Primary outcomes included technical success and stent deployment success, while secondary outcomes encompassed major adverse cardiovascular events (MACE), all-cause mortality, recurrent angina, and target lesion revascularization. Logistic regression was utilized to identify predictors of mortality. The ad-hoc PCI group exhibited a higher prevalence of comorbidities, including hypertension, diabetes mellitus, smoking history, and multi-vessel disease (all p < 0.05). While technical success and stent deployment success rates were lower in the ad-hoc PCI group (p < 0.05), patients undergoing planned PCI demonstrated significantly lower rates of MACE, all-cause mortality, recurrent angina, and target lesion revascularization (all p < 0.05). Logistic regression analysis identified older age, male gender, hypertension, diabetes mellitus, smoking history, and multi-vessel disease as independent predictors of mortality (all p < 0.05). Importantly, coronary ectasia emerged as an additional predictor of mortality (p = 0.002). Our study indicates that planned PCI is associated with improved procedural outcomes and lower rates of mortality and adverse events compared to ad-hoc PCI in patients with coronary ectasia.

Comparison of Acute Coronary Syndromes in the Earthquake Zone before and in the First Month after the Earthquake: A Single-center and Retrospective Analysis.

Earthquakes can significantly impact both the occurrence and the management of acute coronary syndromes (ACS). This study aimed to investigate the effects of an earthquake on patients with ACS by comparing their clinical and angiographic features before and after the event. We utilized a retrospective observational cohort design, involving 260 ACS patients who underwent coronary angiography. Data on patient characteristics, clinical variables, and procedural details were extracted from medical records. Statistical analyses were conducted to compare the ACS groups pre- and post-earthquake and to assess outcomes, which included in-hospital mortality and complications. After the earthquake, the ACS patients were older and predominantly male. The distribution of ACS subtypes remained similar between the groups. The use of anticoagulation before the procedure decreased after the earthquake, while the usage of other medications remained stable. The incidence of non-critical coronary arteries decreased post-earthquake, and there was a higher frequency of non-intervention in this group. Intervention in the left anterior descending coronary artery was more common after the earthquake. In-hospital mortality was associated with post-earthquake ACS, certain ACS subtypes, shock at admission, bifurcation stenting, and the no-reflow phenomenon. Complete revascularization was found to reduce mortality. The duration of intensive care unit stays was longer before the earthquake, while in-hospital mortality was higher after the earthquake. Gender differences were observed in coronary ectasia, with females being more affected post-earthquake. Earthquakes significantly influence the clinical and angiographic features of ACS cases, thereby affecting mortality rates and revascularization outcomes.

Chronic exposure to high altitude and the presence of coronary ectasia in patients with ST elevation myocardial infarction.

To evaluate the association between chronic exposure to high altitude and the presence of coronary ectasia (CE) in patients with ST-segment elevation myocardial infarction (STEMI) treated in a highly specialized cardiovascular reference hospital in Peru. Retrospective matched case-control study. The cases were patients with CE and controls without CE. The relationship between CE and chronic exposure to high altitude was evaluated considering intervening variables such as arterial hypertension, diabetes mellitus, dyslipidemia, smoking, and hematocrit values. Patients with chronic inflammatory pathologies, chronic obstructive pulmonary disease, and previous revascularization were excluded. Multivariate logistic regression was applied to obtain the OR value and their respective confidence intervals. Eighteen cases and 18 controls were studied, most of them were men with an average age of 65 years. Thirty-six percent of the population came from high altitude; in this group 76.9% had coronary ectasia of the infarct-related artery. The mean hematocrit value was slightly higher in the high-altitude native (46 ± 7% versus 42 ± 5%, p=0.094). Multivariate conditional logistic regression did not find a significant relationship between exposure to high altitude and the risk of presenting CE (OR:6.03, IC95%: 0.30-118, p=0.236). In patients with STEMI, we found no association between chronic exposure to high altitude and coronary ectasia.

Coronary Artery Ectasia as an Autoimmune Disease Paradigm in a Cross-Sectional Case-Control Study

Coronary artery ectasia (CAE) is defined as local or generalized aneurysmal dilatation of the coronary arteries. CAE likely represents an exaggerated form of excessive vascular wall remodeling in different clinical settings such as atherosclerosis, vasculitides, connective tissue disorders, hereditary collagen defects, bacterial infections, and congenital malformations. In the present case-control study, we investigated whether the incidental finding of CAE in patients who undergo coronary angiography is associated with presence of autoimmune reactivity. From 2019 to 2022, we identified all consecutive patients with CAE (n=319) on elective or emergency coronary angiography (n=7,458). We furthermore included 90 patients with nonectatic coronary arteries as a control group. Antinuclear antibody (ANA) titer was measured in both groups using the indirect immunofluorescence method from peripheral blood samples. The prevalence of CAE in our study cohort was 4.3%. Among patients with CAE (n=319), presence of positive Antinuclear antibody (ANA) titer was identified in 128 patients (40%). Only 18 patients (20%) from the control group had positive ANA titer. There was a statistically significant greater percentage of patients with positive ANA titer among patients with CAE than among controls (chi-square=12.39; p <0.001), with an odds ratio of 2.68. Among patients with CAE, there is an increased prevalence of positive ANA titer, suggesting an underlying autoimmune disease. Screening for autoimmune reactivity could be a reasonable diagnostic strategy in patients who undergo coronary angiography with an incidental finding of coronary ectasia because the number needed to screen for positive ANA titer in this subgroup of patients is only 5.

Outlook of coronary ectasia at the National Institute of Cardiology Ignacio Chávez: a cross-sectional study

Outlook of coronary ectasia at the National Institute of Cardiology Ignacio Chávez: a cross-sectional study

Liver fibrosis scores and coronary artery ectasia.

Although scoring systems showing liver fibrosis using non-invasive methods have been accepted as effective tools for predicting cardiovascular risk, their role in predicting coronary ectasia (CAE) has not been evaluated. This study investigated whether aprison (APRI) and fibrosis-4 indices (FIB-4), which are indicators of fibrosis in nonalcoholic fatty liver disease (NAFLD), are associated with CAE. A retrospective, cross-sectional study consisted of 215 patients, 108 with CAE and 107 without CAE, as diagnosed by angiography. The mean age of all patients was 61.8±9.9 yrs, and 171 (78.8 %) were males. The relationships between APRI, FIB-4, NAFLD, and Bard scores and CAE were evaluated. APRI, FIB-4, NAFLD, and Bard scores were independent predictors of CAE. Fib 4, APRI, NAFLD, and Bard scores were higher in the CAE patients. There were a moderate, positive correlations for FIB-4, APRI, and NAFLD scores with coronary ectasia (r=0.55, p&lt;0.001; r=0.52, p&lt;0.001; r=0.51, p&lt;0.001, respectively). A weak-moderate positive correlation was observed between the Bard score and CAE (r=0.34, p&lt;0.001). Univariate and multivariate regression analysis showed that APRI score, low HDL, and Bard score were independent risk factors for CAE ectasia (p&lt;0.001). Cut-off values to predict CAE as determined by ROC curve analysis were: FIB-4 index ≥1.43 (AUC=0.817, 95 % confidence interval (CI): 0.762 to 0.873, p&lt;0.001), APRI index ≥0.25 (AUC=0.804, 95 % CI: 0.745 to 0.862, p&lt;0.001), NAFLD score ≥-0.92 (AUC=0.798, 95 % CI: 0.738 to 0.857.p&lt;0.001), Bard score ≥2 (AUC=0.691, 95 % CI: 0.621 to 0.761, p&lt;0.001). APRI, FIB-4, NAFLD, and Bard scores are associated with CAE.

ACUTE CORONARY SYNDROME REVEALING AN ECTATIC CORONARY NETWORK: THE CHALLENGES OF MANAGEMENT (CASE REPORT)

Coronary ectasia is relatively a rare pathological entity, whose pathophysiological mechanisms and management principles are still poorly understood. Atherosclerosis is the predominant etiology with other causes that can be incriminated at lower percentages. These abnormalities expose to a major risk of intracoronary thrombosis by blood stasis, especially since they are most often associated with stenotic lesions conditioning the prognosis of patients. We report the case of a patient admitted to the emergency room for the management of an acute coronary syndrome without ST segment elevation with on coronary angiography an aspect of diffuse coronary ectasia affecting the 3 main coronary arteries, and we discuss a review of the literature concerning this type of condition and specifics of management.

Multisystem inflammatory syndrome in children and Kawasaki disease; comparison of their clinical findings and one-year follow-up—a cross-sectional study

BackgroundStudies on Multisystem Inflammatory Syndrome in Children (MIS-C) and Kawasaki Disease (KD) have yielded inconsistent results and are lacking in Asian and African countries. This study aimed to compare the laboratory and clinical features, short-term outcomes, and one-year follow-ups of a large cohort of MIS-C and KD patients.MethodsData from 176 MIS-C and 56 KD patients admitted to Tehran Children's Medical Center between January 2021 and January 2022 were collected. Patients were followed up until January 2023.ResultsWhile lymphopenia and thrombocytopenia were more prevalent in MIS-C (73.2% vs. 20% in KD, p < 0.001), KD patients exhibited a higher median white blood cell count and prevalence of anemia, along with higher fibrinogen and erythrocyte sedimentation rate levels (p < 0.001, p < 0.001, p = 0.005, p < 0.001, respectively). MIS-C patients also exhibited lower ejection fraction, a greater occurrence of pericardial effusion, and a higher incidence of coronary aneurysms and ectasia, and ascites. Echocardiography after seven days of treatment showed a reduction in pathologies for both groups, but it was significant only for MIS-C. After one year, coronary artery abnormalities remained in only six cases.ConclusionsIn conclusion, this study highlights differences between MIS-C and KD, including laboratory indices as well as echocardiographic and abdominal ultrasound findings. These findings contribute valuable data on Iranian patients to the existing literature on this topic and have significant implications for accurate diagnosis and improved management of pediatric patients presenting with these conditions.

Clinical and angiographic characteristics of patients with coronary ectasia in a reference hospital

To analyze the clinical and angiographic characteristics of patients with coronary ectasia found on coronary angiography.: Descriptive study of patients admitted to the cardiac catheterization laboratory of the Hospital Guillermo Almenara with coronary ectasia, during the years 2012 to 2020. The frequency of coronary ectasia, clinical, angiographic and coronary flow characteristics were determined.7504 catheterizations were reviewed, and 91 patients were found to have coronary ectasia (1.21%). Of these patients, 71 cases were male (78%), and the mean age was 67.74 ± 9.9 years. The 38.5% of cases were obese or overweight; 39.6% were hypertensive; 11% diabetic; 13.2% smoked; 3.3% had chronic kidney disease and 3.3% had polyglobulia. Sixty-one percent of cases had a diagnosis of acute coronary syndrome, and 24% of cases had high-risk stable angina. The artery most frequently involved by ectasia was the right coronary artery (70%). The average diameter of the ectatic artery was 5.7 mm. Occlusive thrombus was found in 19.8% of cases. There was a significant association between TIMI flow and diameter of the ectatic artery (p=0.000), and there was also an association between coronary ectasia and acute coronary syndrome among patients living at an altitude of more than 2500 m (p=0.000).coronary ectasia was an infrequent entity among patients who underwent coronary angiography, was predominantly male, mainly involved the right coronary artery, was associated with lower TIMI flow, and acute coronary syndrome among residents above 2500 m of altitude.

P306 MANAGEMENT OF MASSIVE EMBOLIZATION OF STRATIFIED THROMBUS FROM A CORONARY ANEURYSM: A CASE OF MUTUAL CAMOUFLAGE

Abstract Introduction We report the intraprocedural, post–procedural management and long–term therapeutic strategy in a case of an acute coronary syndrome caused by occlusion of a posterior interventricular branch (IVP) originating from a segment of the right coronary artery with a normal diameter, but, affected by an aneurysm with an extensive stratified thrombotic formation that embolized during the procedure. Case description: 47–year–old man, a heavy smoker, comes to the emergency room about 24 hours after the onset of constant chest pain. ECG: basically, within the limits. Echocardiogram: mild concentric hypertrophy. Mild infero–basal hypokinesia. Blood tests: troponin 355 pg/ml –&amp;gt; 854 pg/ml (pre–coronarography). On coronary angiography, occlusion of the interventricular branch posterior to the ostium originates from a segment of the right coronary artery of apparently normal diameter. The angioplasty procedure caused the mobilization of extensive parietal thrombotic formation adhering to the distal section of the right coronary artery and in the proximal section of the posterior atrioventricular branch with massive embolization of the posterolateral branches, revealing the presence of a coronary ectasia in the same site, not visible before thrombus mobilization. Discussion The goal of intraprocedural management was to obtain reperfusion of the embolized branches by numerous passages of the manual thromboaspirator and numerous balloon inflations on the embolized branches, without placing stents. The antithrombotic therapeutic strategy was dual antiplatelet therapy (DAPT) with acetylsalicylic acid/ticagrelor 90 mgx2, Tirofiban in the first 12 hours and anticoagulation with enoxaparin (8000 IUx2). Conclusions Coronary angiography at 7 days showed complete disappearance of residual thrombotic formations. The choice of long–term pharmacological strategy was only DAPT with an extension program of over 12 months with ticagrelor 60x2 even though the Pegasus criteria were not present.

Prior COVID-19 infection is associated with increased coronary artery ectasia and higher thrombus burden in acute coronary syndromes

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): This work was part funded by King’s College Hospital R&amp;D Grant and was supported by the Department of Health via a National Institute for Health Research Biomedical Research Centre award to Guy’s &amp; St Thomas’ NHS Foundation Trust in partnership with King’s College London and King’s College Hospital NHS Foundation Trust. AMS is supported by the British Heart Foundation. Background/Introduction The COVID-19 pandemic is associated with a profound inflammatory response and a hypercoagulable state in the acute infection, however little is known on whether endothelial dysfunction and hypercoaguability can persist beyond this phase, as well as its impact on acute coronary syndrome (ACS). Purpose The objective of this study was to investigate the effects of COVID-19 infection on the presentations and outcomes of coronary artery disease in patients with acute coronary syndrome. Methods Blood samples were obtained from all consenting patients aged 18 or over presenting between 10/06/2020 and 06/05/2021 with suspected ACS. Participants were excluded if they had active COVID-19 infection or if they did not undergo coronary angiography on admission. The blood samples were tested for COVID-19 nucleocapsid antibody and anti-SARS-CoV-2 spike protein receptor binding domain (RBD) antibody levels to determine whether the participants had prior COVID-19 infection, COVID-19 vaccination, or neither at the time of their presentation. Baseline demographics, clinical presentation and coronary angiographic findings were recorded. The patients were followed up at 30 days and 1 year. The primary endpoint was all-cause mortality. The pre-specified secondary endpoints were stroke, repeat MI, unplanned revascularisation or death at 1-year, coronary artery ectasia (defined as dilatation of an arterial segment at least 1.5 times that of the adjacent normal coronary artery), presence of thrombus, and thrombectomy requirement. Results Of the 280 patients who consented for the study, 5 patients dropped out, 8 were lost to follow-up, 2 did not undergo coronary angiography, and 98 had uninterpretable blood samples for antibody analysis. In the final analysis of the study population of 167 patients (median age 64), 22 (13.1%) had prior infection, 76 (45.5%) were negative for COVID-19 antibodies and 69 (41.3%) were vaccinated. There were no differences in rates of STEMI between the different study groups. There was no difference in the primary endpoint between the groups. However, patients with prior COVID-19 infection were more likely to have coronary ectasia compared to vaccinated and antibody negative patients (57.71% vs 27.5% and 30.3%, respectively p = 0.034). They were also more likely to have thrombus present on angiography (61.9% vs 33.3% and 52.6%, p = 0.019) and more likely to require thrombectomy (19.0% vs 4.3% and 3.9%, p=0.027). Patients with prior COVID-19 infection were also more likely to present with myocarditis (18.2% vs 1.4% and 1.3%, p&amp;lt;0.001). Conclusion In summary, our findings support the notion that COVID-19 infection leads to persistent endothelial dysfunction and hypercoagulability which portends increased severity of coronary artery ectasia and coronary thrombosis even after recovery from the initial infection.

Outlook of coronary ectasia at the National Institute of Cardiology Ignacio Chávez: a cross-sectional study.

Coronary Ectasia (CE) is a pathological remodeling with a low worldwide prevalence. It is defined as a diffuse dilatation greater than 1.5 times the diameter of the adjacent segments of the same or different coronary arteries. To document the clinical and angiographic characteristics, and medical treatment at the discharge of patients diagnosed with coronary ectasia who attended the National Institute of Cardiology (INC). Cross-sectional study with a non-experimental descriptive design, with a non-probabilistic convenience sampling. Of 69 patients who attended the INC with a diagnosis of CD, most were men, with a mean age of 56 + 11 years, the most common coronary risk factor in patients with CE was smoking 58% (40); it was associated mostly with an acute myocardial infarction ST-segment elevation (STEMI) 65.2% (45), of frequent location in the lower face 40% (18), correlated with the most affected artery is the Right Coronary Artery (CD) 69.6% (48), followed by the circumflex (Cx) 56.5% (39). A mean LVEF of 47 + 9.72 was evident within the ventricular function. As well as the preferential use of dual antiplatelet therapy with anticoagulant (DAP + OAC) in 58% (40) at the discharge of each patient from the INC. CE is a not uncommon pathological remodeling in INC. This study showed that STEMI is the most typical manifestation of CE, diagnostic coronary angiography identified a type 3 Markis, so a low rate of mortality and recurrence of cardiovascular events would be expected, and despite the lack of consensus on the ideal therapy, at the INC individualized treatment is preferred, recommending lifestyle changes, and using triple therapy (DAP + OAC) as a medical treatment only at the time of patient discharge.