Ignite Creation Date:
2024-05-06 @ 12:58 PM
Last Modification Date:
2024-10-26 @ 1:06 PM
Study NCT ID:
NCT03896321
Status:
COMPLETED
Last Update Posted:
2024-02-13
First Post:
2019-03-23
Brief Title:
Coronary Artery Ectasia in Elective Coronary Angiography Predictors Outcomes and Management
Sponsor:
Assiut University
Organization:
Assiut University
Study Overview
Official Title:
Coronary Artery Ectasia in Elective Coronary Angiography Predictors Outcomes and Management
Status:
COMPLETED
Status Verified Date:
2024-02
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
Coronary artery ectasia CAE is the diffuse dilatation of coronary artery It is defined as a dilatation with a diameter of 15 times the adjacent normal coronary artery Its prevalence ranges from 12-49 with male to female ratio of 31
Coronary ectasia likely represents an exaggerated form of expansive vascular remodelling ie excessive expansive remodelling in response to atherosclerotic plaque growth
CAE is more common in males Hypertension is a risk Factor Interestingly patients with DM have low incidence of CAE This may be due to down regulation of MMP with negative remodelling in response to atherosclerosis Smoking appears to be more common in patients with CAE than in those with coronary artery disease CAD
The angiographic classification for CAE described by Markis et al categorizes the severity based on the extent of coronary arterial involvement Type 1 Diffuse ectasia of 2-3 arteries Type 2 Diffuse ectasia in one artery and localized in another Type 3 Diffuse single arterial ectasia Type 4 Localized or segmental ectasia
Stable angina is the most common presentation in patients with CAE Patients with CAE without stenosis had positive results during treadmill exercise tests ST-elevation myocardial infarction MI non-ST elevation MI can occur from altered blood flow by distal embolization or occlusion of ectatic segment with thrombus
Medical management for CAE is a controversial area as there is lack of evidence based medicine especially the role of antiplatelet versus anticoagulant agents Aspirin was suggested in all patients because of coexistence of CAE with obstructive coronary lesions in the great majority of patients and the observed incidence of myocardial infarction even in patients with isolated coronary ectasia The role of dual anti platelet therapy has not been evaluated in prospective randomized studies Based on the significant flow disturbances within the ectatic segments chronic anticoagulation with warfarin as main therapy was suggested
Coronary ectasia likely represents an exaggerated form of expansive vascular remodelling ie excessive expansive remodelling in response to atherosclerotic plaque growth
CAE is more common in males Hypertension is a risk Factor Interestingly patients with DM have low incidence of CAE This may be due to down regulation of MMP with negative remodelling in response to atherosclerosis Smoking appears to be more common in patients with CAE than in those with coronary artery disease CAD
The angiographic classification for CAE described by Markis et al categorizes the severity based on the extent of coronary arterial involvement Type 1 Diffuse ectasia of 2-3 arteries Type 2 Diffuse ectasia in one artery and localized in another Type 3 Diffuse single arterial ectasia Type 4 Localized or segmental ectasia
Stable angina is the most common presentation in patients with CAE Patients with CAE without stenosis had positive results during treadmill exercise tests ST-elevation myocardial infarction MI non-ST elevation MI can occur from altered blood flow by distal embolization or occlusion of ectatic segment with thrombus
Medical management for CAE is a controversial area as there is lack of evidence based medicine especially the role of antiplatelet versus anticoagulant agents Aspirin was suggested in all patients because of coexistence of CAE with obstructive coronary lesions in the great majority of patients and the observed incidence of myocardial infarction even in patients with isolated coronary ectasia The role of dual anti platelet therapy has not been evaluated in prospective randomized studies Based on the significant flow disturbances within the ectatic segments chronic anticoagulation with warfarin as main therapy was suggested
Detailed Description:
None
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
False
Is an FDA AA801 Violation?:
None