Inflammatory Biomarkers in Coronary Artery Ectasia: A Systematic Review and Meta-Analysis

Shrivastava

Indian Journal of Clinical Cardiology

et al. 2023

Some individuals develop a rare form of coronary heart disease called coronary artery ectasia (CAE). It is characterized by a dilation of more than one-third of the length of a coronary artery and a diameter that is 1.5 times that of the adjacent normal coronary artery. In the absence of significant coronary constriction, angina pectoris, positive stress tests, and acute coronary syndromes may all be indications of CAE. A distal embolization, vasospasm, or vascular rupture may cause thrombus formation in an ectatic artery. Antiplatelets, such as aspirin, are the cornerstone of treatment for people with CAE. Anticoagulants are used to prevent thrombus formation based on the presence of concurrent obstructive coronary artery disease and the patient’s risk of bleeding. As atherosclerosis is the most common cause of CAE, all patients are advised to take statins for primary prevention. Due to their anti-inflammatory properties, angiotensin-converting enzyme inhibitors may be prescribed to individuals with hypertension. If hypertension and coronary vasospasm occur simultaneously, beta-blockers and calcium channel blockers may be beneficial. Because they may aggravate symptoms, nitrates are normally not suggested. Other CAE treatment methods include the prevention of thromboembolic complications and percutaneous or surgical revascularization. CAE prognosis is determined on the severity of the associated coronary artery.

Section: Diagnosismentioning

confidence: 99%

Coronary Artery Ectasia

Shrivastava

Indian Journal of Clinical Cardiology

et al. 2023

Coronary Artery Disease

“…The close association of increased intestinal permeability with atherosclerosis may explain the relationship between CAE and increased intestinal permeability. The causal relationship between circulating inflammatory markers and CAE has been demonstrated in previous studies [5–8,31]. It has been shown that inflammatory markers in the circulation increase with the increase in intestinal permeability [32].…”

Section: Discussionmentioning

confidence: 70%

Can increased intestinal permeability and low-grade endotoxemia be the triggering pathogenesis in isolated coronary artery ectasia?

Toprak

Kaplangöray

Altıparmak

et al. 2022

Purpose Isolated coronary artery ectasia (ICAE) is a rare coronary artery disease (CAD) encountered during coronary angiography. Although many mechanisms have been suggested today that may be associated with ICAE, the underlying pathogenesis has not been fully understood. In this study, we aimed to reveal the possible relationship between intestinal permeability and ICAE. Methods Of the 12 850 patients who underwent coronary angiography, 138 consecutive patients with ICAE and 140 age- and sex-matched subjects with normal coronary arteries as the control group and 140 subjects with stenotic CAD were included in the study. Results Serum zonulin and lipopolysaccharide levels were significantly higher in patients with ICAE than in the control group and CAD group. Additionally, zonulin and lipopolysaccharide levels were significantly higher in the CAD group than in the ICAE group. In the correlation analysis, serum zonulin levels were correlated with the mean diameter and length of the ecstatic segment. In multivariate analysis, zonulin and lipopolysaccharide were identified as independent predictors for ICAE. Conclusion These results suggest that there may be a pathophysiological relationship between increased intestinal permeability and ICAE.

Arch Med Sci Atheroscler Dis

“…Yıldırım et al found that the cellular adhesion molecules CD-16 and CD 45 increased in patients with CAE [ 44 ]. In a large meta-analysis published recently, hs-CRP, IL-6, TNF-α, and RDW levels were found to be high in the CAE group [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

Increased serum resistin levels associated with in patients with isolated coronary artery ectasia

Sivri¹,

Eryılmaz²

2022

IntroductionCoronary artery ectasia (CAE) is localized or diffuse enlargement of the coronary artery more than 1.5 times in diameter in comparison with the adjacent normal coronary artery. The etiology and pathophysiology of CAE are not fully elucidated. Resistin is a newly identified adipocyte secreted hormone belonging to a cysteine-rich protein family. Recently it has been found to be relevant to inflammation-related disease and correlated with serum C-reactive protein (CRP). This research aimed to investigate whether the resistin level has a role in CAE etiopathogenesis.Material and methodsA hundred and three patients with diagnosis of CAE and 122 with normal coronary anatomy (NCA) were included. Details of baseline clinical characteristics and angiographic findings were recorded. Other necessary biochemical parameters were measured with an autoanalyzer. Blood was collected and stored for serum resistin level analysis.ResultsSerum resistin levels in CAE were higher than in the NCA group and were statistically significant (p = 0.001). Hypertension (OR = 1.006, 95% CI: 1.002–1.008, p = 0.025), tobacco use (OR = 1.089, 95% CI: 1.055–1.124, p < 0.001), serum resistin levels (OR = 2.431, 95% CI: 1.100–4.696, p = 0.01), hyperlipidemia (OR = 1.005, 95% CI: 1.000–1.014, p = 0.004), triglyceride (OR = 1.006, 95% CI: 1.001–1.010, p = 0.012) remained as independent factors for CAE. In the subgroup analysis of the CAE group, in patients with ectasia in three coronary arteries, resistin levels were significantly higher and statistically significant (p = 0.001). In ROC analysis, the sensitivity of serum resistin was 67.6% and specificity was 86.7% (AUC = 0.749, 95% CI: 0.621–0.877, p = 0.0001).ConclusionsSerum resistin level was significantly higher in CAE. In addition this study showed that serum resistin levels are directly proportional to the number of coronary arteries with ectasia. We think that this study will shed light on this subject and encourage further studies in this field.