Ischemia and Inflammatory Markers Among Patients With Coronary Artery Ectasia

Обзор

study the ischemic burden in patients with CAE, and its relation to inflammatory markers. * To assess the ischemic response during exercise ECG among patients with different variants of CAE. * To assess inflammatory biomarkers among patient with different variants of CAE * To assess the relation between the ischemic response and inflammatory markers.

Подробное описание

Coronary artery ectasia (CAE) is a dilation of the coronary artery lumen. The term "ectasia" refers to diffuse dilation of a coronary artery, while focal coronary dilation is called a "coronary aneurysm." The definition of coronary artery ectasia is a dilatation exceeding more than one-third of the coronary artery length with the diameter of the dilated segment measuring more than 1.5 times the diameter of a normal adjacent segment. Coronary artery ectasia is well recognized, but uncommon findings encountered during diagnostic coronary angiography.

inflammation, platelet activation, endothelial dysfunction, microvascular dysfunction, slow flow and vascular remodeling have all been suggested to play a role .

. Available evidence implies that CAE is not a mere variant of CAD; indeed diabetes is negatively associated with CAE and studies pinpoint a critical inflammatory component

Turbulent slow flow within dilated coronaries may lead to platelet activation, thrombosis and eventually acute coronary syndrome Local coronary flow disturbances caused by decreased endothelial shear stress has also been proposed as an alternative explanation for the coexistence of CAD and CAE. Intravascular ultrasound (IVUS) evidence suggests that atherosclerotic plaques within ectatic regions of vessels are highly inflamed and meet high-risk plaque criteria

Mediators of chronic inflammation, such as growth factors and cellular adhesion models, have been widely described in the pathogenesis of CAE. Specifically, the expression of specific inflammatory markers, particularly IL-6 and CRP, is known to be higher in CAE compared with CAD and healthy controls . Most recently, a large meta-analysis elucidated the role of other contributory markers, neutrophil to lymphocyte ratio (NLR) and red cell distribution width (RDW), in the pathogenesis of CAE

Inflammatory markers, C-reactive protein and albumin are believed to be involved in the progression and severity of CAE. Recently, a significantly higher C-reactive protein-to-albumin ratio has been associated with isolated CAE when compared to obstructive CAD and controls. Notably, C-reactive protein-to-albumin ratio also correlated strongly with the severity of CAE, which provides further evidence for its potential role in detection and management

We sought to study the ischemic burden in patients with CAE, and its relation to inflammatory markers.

Вмешательства

• Диагностический тест stress ECG
  stress ECG to patients suspected to be ischemic patients .

Первичные конечные точки

• Ischemia and Inflammatory markers among patients with coronary artery ectasia . [Срок оценки: 2 years]

Вторичные конечные точки (1)

• Ischemia and Inflammatory markers among patients with coronary artery ectasia . [Срок оценки: 2 years]

Критерии участия

Критерии включения

• Subjects with suspected CAD who are undergoing elective coronary angiography.

Критерии исключения

Patients with a history of cardiomyopathy or myocardial infarction (MI). Patients with recent acute coronary syndrome Patients with severe renal impairment Post CABG patients Patients with physical incapacity

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Да

Дизайн исследования

Модель наблюдения

Случай-контроль

Центры проведения

Список центров уточняется — проверьте первичный протокол.

Публикации

• Mavrogeni S. Coronary artery ectasia: from diagnosis to treatment. Hellenic J Cardiol. 2010 Mar-Apr;51(2):158-63. No abstract available. PMID 20378518
• Aboeata AS, Sontineni SP, Alla VM, Esterbrooks DJ. Coronary artery ectasia: current concepts and interventions. Front Biosci (Elite Ed). 2012 Jan 1;4(1):300-10. doi: 10.2741/377. PMID 22201872
• Eitan A, Roguin A. Coronary artery ectasia: new insights into pathophysiology, diagnosis, and treatment. Coron Artery Dis. 2016 Aug;27(5):420-8. doi: 10.1097/MCA.0000000000000379. PMID 27218145
• Devabhaktuni S, Mercedes A, Diep J, Ahsan C. Coronary Artery Ectasia-A Review of Current Literature. Curr Cardiol Rev. 2016;12(4):318-323. doi: 10.2174/1573403x12666160504100159. PMID 27142049
• Huang QJ, Liu J, Chen MH, Li JJ. Relation of diabetes to coronary artery ectasia: A meta-analysis study. Anadolu Kardiyol Derg. 2014 Jun;14(4):322-7. doi: 10.5152/akd.2014.5327. Epub 2014 May 2. PMID 24818774
• Antoniadis AP, Chatzizisis YS, Giannoglou GD. Pathogenetic mechanisms of coronary ectasia. Int J Cardiol. 2008 Nov 28;130(3):335-43. doi: 10.1016/j.ijcard.2008.05.071. Epub 2008 Aug 9. PMID 18694609
• Dereli S, Cerik IB, Kaya A, Bektas O. Assessment of the Relationship Between C-Reactive Protein-to-Albumin Ratio and the Presence and Severity of Isolated Coronary Artery Ectasia. Angiology. 2020 Oct;71(9):840-846. doi: 10.1177/0003319720930983. Epub 2020 Jun 10. PMID 32519552
• Shao Q, Chen K, Rha SW, Lim HE, Li G, Liu T. Usefulness of Neutrophil/Lymphocyte Ratio as a Predictor of Atrial Fibrillation: A Meta-analysis. Arch Med Res. 2015 Apr;46(3):199-206. doi: 10.1016/j.arcmed.2015.03.011. Epub 2015 May 14. PMID 25980945

Идентификаторы

NCT: NCT05692115 · Stress ECG,inflammation in CAE

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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