Objective: Coronary artery ectasia (CAE) is an uncommon finding at cardiac catheterisation. Our objective was to retrospectively assess the angiographic prevalence of CAE and its clinical expression.
Methods: From January 1999 to June 2001, 3870 consecutive patients underwent coronary angiography at our catheterisation laboratory.
Results: The prevalence of CAE was 3.6%. Most patients were male (89.2%). Type 1 CAE was observed in 20% of patients, type 2 in 11%, type 3 in 43%, and type 4 in 26%. The right coronary artery was most commonly involved (75%). In 55 patients with acute myocardial infarction, CAE within the culprit vessel was found in 32 patients (58.1%): ectasia was associated with stenosis in 29 patients, whereas isolated CAE was observed in only three patients. In 23 patients (41.8%), CAE was detected as a collateral finding in the presence of the culprit occluded, non-ectatic vessel. Overall, in the 109 patients (78%) with acute coronary syndrome, the culprit lesion was found to be related to the ectatic vessel in 46 patients (33.1%): ectasia was associated with stenosis in 39 patients, whereas isolated CAE was observed in only seven patients. In 66.9% CAE was an incidental finding on angiography. At follow-up, three patients with CAE died (2%).
Conclusions: In our investigation, the angiographic prevalence of CAE was 3.6%. CAE occurred predominantly in males and more often affected the right coronary artery. It was associated with acute coronary syndrome in one third of cases. Isolated CAE was associated with a good prognosis at follow-up.