Coronary artery aneurysm presenting as acute coronary syndrome: two case reports and a review of the literature

Taşkesen, Tuncay; Osei, Kofi; Ugwu, Justin; Hamilton, Russell J.; Tannenbaum, Mark; Ghali, Magdi

doi:10.1007/s11239-021-02418-2

Cited by 5 publications

(12 citation statements)

References 16 publications

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“…Ultrasonography has high sensitivity and specificity through the enhancement of scattered echoes by the use of contrast agents, which enhances ultrasound diagnostic discrimination [1]. LP-PLA2 is a key indicator in the study of clinical vascular disease and an independent risk factor for cardiovascular disease mostly used to study inflammatory response mediators [2]. e pathological basis of ACS in the elderly is the rupture of coronary atherosclerotic plaque, followed by complete or incomplete occlusive thrombosis [3].…”

Section: Discussionmentioning

confidence: 99%

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The Diagnostic Value of Combined Detection of Serum Lp-PLA2 and Hcy and Color Doppler in Elderly Patients with Acute Coronary Syndrome and Effect on Endothelial Function

Zhao

Luo

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Objective. To evaluate the application value of serum lipoprotein-associated phospholipase A2 (Lp-PLA2) and homocysteine (Hcy) combined with color Doppler detection in elderly patients with acute coronary syndrome (ACS) and the influence on their endothelial function. Methods. From February 2019 to October 2020, 100 elderly patients with suspected ACS treated in our hospital were recruited and assigned (1 : 1) to a control group or an experimental group. The control group received color Doppler detection, and the experimental group received the combined detection of serum Lp-PLA2 and Hcy and color Doppler. Positive results were determined by the combined detection of the levels of LP-PLA2 and Hcy and color Doppler. The two groups were compared in terms of specificity, susceptibility, positive detection rate, negative detection rate, test accuracy, the area under the receiver operating characteristic (ROC) curve (AUC), the expression levels of interleukin-2 (IL-2), interleukin-12 (IL-12), interleukin-13 (IL-13), and the vascular endothelial function. The patients with ACS were divided into three subgroups according to the Gensini score three-quartile interval, and their Lp-PLA2 levels were calculated for analysis. Results. The test specificity, susceptibility, positive detection rate, negative detection rate, test accuracy, and AUC in the experimental group were much better than the those in the control group (all P < 0.05 ), and there were no significant differences in the expression levels of IL-2, IL-12, IL-13, and vascular endothelial function between the two groups ( P > 0.05 ). The three subgroups showed similar levels of fasting blood glucose, total cholesterol, triglyceride, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, apolipoprotein A-I, glutamic-pyruvic transaminase, lutamic-oxaloacetic transaminase, homocysteine, and amino-terminal pro-brain natriuretic peptide (all P > 0.05 ). The severe condition group had the highest Lp-PLA2 level, followed by the moderate group, and then the mild group ( P < 0.05 ). Moreover, the levels of LP-PLA2, aspartate transaminase (AST), and N-terminal pro hormone B-type natriuretic peptide (NT-proBNP) were all influencing factors for the coronary Gensini score (all P < 0.05 ). Conclusion. The combined detection of serum Lp-PLA2, Hcy, and color Doppler significantly improves the diagnostic accuracy, specificity, and susceptibility in the elderly with ACS, with little impact on their vascular endothelial function.

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Section: Discussionmentioning

confidence: 99%

“…Acute coronary syndrome (ACS) refers to a series of acute symptoms caused by changes in the position of plaques in the coronary arteries that a ect the ow of blood in the arteries. Such symptoms can cause acute myocardial ischemia, myocardial infarction, angina, and thrombus [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

The Diagnostic Value of Combined Detection of Serum Lp-PLA2 and Hcy and Color Doppler in Elderly Patients with Acute Coronary Syndrome and Effect on Endothelial Function

Zhao

Luo

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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“…Additional anticoagulants or prolonged dual antiplatelet therapy could be considered for aneurysms with multivessel disease or in cases of high thrombotic risk, and they were prescribed in only 13.4% of patients [ 13 ]. Recent studies have suggested a possible advantage of anticoagulation in patients with acute coronary syndrome [ 15 ]. A retrospective study suggested that more intense and prolonged antithrombotic treatment may result in lower mortality rates [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…A retrospective study suggested that more intense and prolonged antithrombotic treatment may result in lower mortality rates [ 12 ]. Nowadays, the use of direct anticoagulants is widespread, but experience in CAA is also scarce and based on case reports [ 15 ]. Glycoprotein IIb/IIIa receptor inhibitors may be an adjunctive therapy to PCI, due to the frequency of major thrombus burden, mainly in acute coronary syndrome [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“Floating” Stent in a Coronary Aneurysm Presenting as ST-Elevation Myocardial Infarction

Castro

Garcia-Gomez

Domínguez

et al. 2023

JCDD

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Coronary artery aneurysm (CAA) presenting as an ST-elevation myocardial infarction (STEMI) represents a clinical challenge due to the technical difficulties in the percutaneous management of this specific situation. Appropriate treatment for CAA depends on the precise clinical situation and consists of medical management, surgical resection, or/and stent placement. The high rate of complications during percutaneous intervention (distal thrombus embolization, no-reflow phenomenon, stent malposition, or dissection) makes emergent surgery a frequent situation in these cases. We present the case of a 50-year-old man with a STEMI due to thrombotic occlusion of CAA. Specific angiographic techniques and intracoronary imaging help with the percutaneous management of acute thrombotic occlusions in CAA, providing a less invasive approach than emergent surgery.

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“…Although the exact pathophysiology of CAAs has not been yet identified, atherosclerosis is commonly considered to be the primary cause of CAAs among adults [ 7 , 8 ]. Additional predisposing characteristics include male gender and cardiovascular risk factors such as hypertension, dyslipidemia, diabetes mellitus, smoking, and obesity [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Coronary Artery Aneurysms as a Cause of Acute Coronary Syndrome Presentation - A Focused Review

Latif

Tran

Ahsan

et al. 2023

CCR

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Coronary artery aneurysms (CAA) are defined as a dilation of a coronary vessel greater than 1.5 times the diameter of a local reference vessel. While CAAs tend to be incidental findings on imaging, they result in complications, such as thrombosis, embolization, ischemia, arrhythmias, and heart failure. Among symptomatic cases, chest pain has been the most common manifestation of CAAs. This necessitates an understanding of CAAs as a cause of acute coronary syndrome (ACS) presentation. However, due to the unclear pathophysiology of CAAs and their variable presentation complicated by similar ACS conditions, there is no clear strategy for CAA management. In this article, we will discuss the contribution of CAAs to ACS presentations and review the current management options for CAAs.

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Coronary artery aneurysm presenting as acute coronary syndrome: two case reports and a review of the literature

Cited by 5 publications

References 16 publications

The Diagnostic Value of Combined Detection of Serum Lp-PLA2 and Hcy and Color Doppler in Elderly Patients with Acute Coronary Syndrome and Effect on Endothelial Function

The Diagnostic Value of Combined Detection of Serum Lp-PLA2 and Hcy and Color Doppler in Elderly Patients with Acute Coronary Syndrome and Effect on Endothelial Function

“Floating” Stent in a Coronary Aneurysm Presenting as ST-Elevation Myocardial Infarction

Coronary Artery Aneurysms as a Cause of Acute Coronary Syndrome Presentation - A Focused Review

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