1. Coronary artery aneurysms, insights from the international coronary artery aneurysm registry (CAAR)
- Author
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Fernando Alfonso, Tamara Garcia Camarero, Eric H. Yang, Alejandro Sánchez-Grande Flecha, Javier Escaned, Roman Miklík, Ramez Morkous, Christoph Berndt, Pablo Salinas, Piera Capasso, Gustavo Vignolo, Maria Del Trigo, Paol Rojas, Daniel Bautista, Pilar Jiménez Quevedo, Peter R. Stella, César Morís, Pierluigi Omedè, Pablo Avanzas, Pedro Trujillo, Jose Alberto de Agustin, Santiago Jesús Camacho Freire, Simone Calcagno, Carlos Macaya, Mohamad Alkhouli, Iñigo Lozano, Iván J. Núñez-Gil, Juan Albistur, Antonio Gomez Menchero, Nurilign Bulcha, Joan Antoni Gómez-Hospital, Alfonso Ielasi, Gonzalo Navarrete, Roberto Latini, Marco Pavani, Ahmad Al Hallak, Fatih Arslan, Alfonso de Hoyos y Fernández de Córdova, Massimo Mancone, Mario Bollati, Bernardo Cortese, David Vivas, Ramón Rodríguez-Olivares, Claudio Moretti, Francesco Casilli, José Francisco Díaz Fernandez, Martin Poloczek, Jorge Palazuelos Molinero, Daniella Benedetto, Christoph Liebetrau, Jose A. Linares, Sarabjeet S. Suri, Jesus Jimenez Mazuecos, Javier Cuesta, Enrico Cerrato, Giulietta Grigis, Cristina Rolfo, Antonio Montefusco, Manuel Vargas Torres, Antonio Fernández-Ortiz, Armghan Munir, Dámaris Carballeira, Andrés Íñiguez Romo, Boshra Louka, Rafael Mila, Fabrizio Ugo, Petr Kala, Agustín Fernández Cisnal, Harish Ramakrishna, Ferdinando Varbella, Massimo Medda, Juan Pablo Canepa Leite, José M. de la Torre Hernández, Benjamín Camacho, Rafael Gómez Vicente, Francesco Tomassini, Davide Piraino, Dario Buccheri, José Antonio Baz Alonso, Giorgio Quadri, Gisela Feltes, Mohammed Makkiya, Rodrigo Bagur, Fabrizio D'Ascenzo, Fernando Rivero, Luis Nombela-Franco, Etelberto Hernández Hernández, Ignacio J. Amat Santos, Pedro A. Villablanca, Pedro Gabriel Melo de Barros e Silva, Mª. Isabel Barrionuevo Sánchez, Giulia Teresi, Giuseppe Andolina, Marta Bande, Emilio Alfonso-Rodríguez, Piter Martínez Benítez, Victor Alfonso Jimenez-Diaz, Isaac Pascual, Patricia Clares Montón, Javier León Jiménez, Belén Terol, Nieves Gonzalo, and Geoffrey Yanes Bowden
- Subjects
Male ,medicine.medical_specialty ,Acute coronary syndrome ,Percutaneous ,Internationality ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Revascularization ,Coronary Angiography ,03 medical and health sciences ,0302 clinical medicine ,Aneurysm ,Percutaneous Coronary Intervention ,Internal medicine ,medicine ,Humans ,cardiovascular diseases ,030212 general & internal medicine ,Registries ,Aged ,Coronary artery aneurysm ,coronary artery aneurysms ,intravascular ultrasound ,eluting stent ,implantation ,business.industry ,Coronary Aneurysm ,Middle Aged ,medicine.disease ,3. Good health ,medicine.anatomical_structure ,Conventional PCI ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Mace ,Platelet Aggregation Inhibitors ,Artery ,Follow-Up Studies - Abstract
Background Coronary Aneurysms are a focal dilatation of an artery segment >1.5-fold the normal size of adjacent segments. Although some series have suggested a prevalence of 0.3–12%, data are lacking. In addition, they are not mentioned in practice guidelines. Our aim was investigate its prevalence, management and long-term outcomes. Methods and results The coronary artery aneurysm registry (CAAR) involved 32 hospitals across 9 countries in America and Europe. We reviewed 436,467 consecutive angiograms performed over the period 2004–2016. Finally, 1565 patients were recruited. Aneurysm global prevalence was 0.35%. Most patients were male (78.5%) with a mean age of 65 years and frequent cardiovascular risk factors. The main indication for angiogram was an acute coronary syndrome, 966 cases. The number of aneurisms was ≤2 per patient in 95.8% of the cases, mostly saccular, most frequently found in the left anterior descending and with numbers proportional with coronary stenosis. Aortopathies were related with more aneurysms too. Most patients received any revascularization procedure (69%), commonly percutaneous (53%). After a median follow-up of 37.2 months, 485 suffered a combined event (MACE) and 240 died. Without major differences comparing CABG vs PCI, MACE and death were more frequent in patients who received bare metal stents. Conclusions Coronary artery aneurysms are not uncommon. Usually, they are associated with coronary stenosis and high cardiovascular risk. Antiplatelet therapy seems reasonable and a percutaneous approach is safe and effective.
- Published
- 2020