Outcomes of coronary artery aneurysms: insights from the Coronary Artery Ectasia and Aneurysm Registry (CAESAR)
BACKGROUND: Coronary artery ectasias and aneurysms (CAE/CAAs) are among the less common forms of coronary artery disease, with undefined long-term outcomes and treatment strategies. AIMS: To assess the clinical characteristics, angiographic patterns, and long-term outcomes in patients with CAE, C...
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SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
2025-01-01
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| Series: | Swiss Medical Weekly |
| Online Access: | https://smw.ch/index.php/smw/article/view/3857 |
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| author | Alessandro Candreva Jessica Huwiler Diego Gallo Victor Schweiger Thomas Gilhofer Roberta Leone Michael Würdinger Maurizio Lodi Rizzini Claudio Chiastra Julia Stehli Jonathan Michel Alexander Gotschy Barbara E. Stähli Frank Ruschitzka Umberto Morbiducci Christian Templin |
| author_facet | Alessandro Candreva Jessica Huwiler Diego Gallo Victor Schweiger Thomas Gilhofer Roberta Leone Michael Würdinger Maurizio Lodi Rizzini Claudio Chiastra Julia Stehli Jonathan Michel Alexander Gotschy Barbara E. Stähli Frank Ruschitzka Umberto Morbiducci Christian Templin |
| author_sort | Alessandro Candreva |
| collection | DOAJ |
| description |
BACKGROUND: Coronary artery ectasias and aneurysms (CAE/CAAs) are among the less common forms of coronary artery disease, with undefined long-term outcomes and treatment strategies.
AIMS: To assess the clinical characteristics, angiographic patterns, and long-term outcomes in patients with CAE, CAA, or both.
METHODS: This 15-year (2006–2021) retrospective single-centre registry included 281 patients diagnosed with CAE/CAA via invasive coronary angiography. Major adverse cardiovascular events included all-cause death, non-fatal myocardial infarction, unplanned ischaemia-driven revascularisation, hospitalisation for heart failure, cerebrovascular events, and clinically overt bleeding. Time-dependent event risks for the CAE and CAA groups were assessed using Cox regression models and Kaplan-Meier curves.
RESULTS: CAEs (n = 161, 57.3%) often had a multi-district distribution (45.8%), while CAAs (78, 27.8%) exhibited a single-vessel pattern (80%). The co-existence of CAAs and CAE was observed in 42 cases (14.9%), and multi-vessel obstructive coronary artery disease was prevalent (55.9% overall). Rates of major adverse cardiovascular events were 14.3% in-hospital and 38.1% at a median follow-up of 18.9 (interquartile range [IQR] 6.0–39.9) months. The presence of CAAs was associated with increased major adverse cardiovascular events risk in comparison to CAE (hazard ratio [HR] = 2.26, 95% confidence interval [CI] 1.38–3.69, p = 0.001), driven by a higher hazard ratio of non-fatal myocardial infarctions (HR = 5.00, 95% CI 1.66–15.0, p = 0.004) and unplanned ischaemia-driven revascularisation in both dilated (HR = 3.23, 95% CI 1.40–7.45, p = 0.006) and non-dilated coronary artery segments (HR 3.83, 95% CI 2.08–7.07, p = 0.001).
CONCLUSIONS: Overlap between obstructive and dilated coronary artery disease is frequent. Among the spectrum of dilated coronary artery disease, the presence of a CAA was associated with worse long-term outcomes.
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| format | Article |
| id | doaj-art-292c5a201e9b4b598f9ce58fa8c474f3 |
| institution | Kabale University |
| issn | 1424-3997 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | SMW supporting association (Trägerverein Swiss Medical Weekly SMW) |
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| series | Swiss Medical Weekly |
| spelling | doaj-art-292c5a201e9b4b598f9ce58fa8c474f32025-01-09T20:45:47ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972025-01-01155110.57187/s.3857Outcomes of coronary artery aneurysms: insights from the Coronary Artery Ectasia and Aneurysm Registry (CAESAR)Alessandro Candreva0Jessica Huwiler1Diego Gallo2Victor Schweiger3Thomas Gilhofer4Roberta Leone5Michael Würdinger6Maurizio Lodi Rizzini7Claudio Chiastra8Julia Stehli9Jonathan Michel10Alexander Gotschy11Barbara E. Stähli12Frank Ruschitzka13Umberto Morbiducci14Christian Templin15University Hospital ZurichUniversity of ZurichPolitecnico di TorinoUniversity of ZurichUniversity Hospital ZurichUniversity Hospital ZurichUniversity Hospital ZurichPolitecnico di TorinoPolitecnico di TorinoUniversity Hospital ZurichUniversity Hospital ZurichUniversity Hospital ZurichUniversity Hospital ZurichUniversity Hospital ZurichPolitecnico di TorinoUniversity Hospital Zurich BACKGROUND: Coronary artery ectasias and aneurysms (CAE/CAAs) are among the less common forms of coronary artery disease, with undefined long-term outcomes and treatment strategies. AIMS: To assess the clinical characteristics, angiographic patterns, and long-term outcomes in patients with CAE, CAA, or both. METHODS: This 15-year (2006–2021) retrospective single-centre registry included 281 patients diagnosed with CAE/CAA via invasive coronary angiography. Major adverse cardiovascular events included all-cause death, non-fatal myocardial infarction, unplanned ischaemia-driven revascularisation, hospitalisation for heart failure, cerebrovascular events, and clinically overt bleeding. Time-dependent event risks for the CAE and CAA groups were assessed using Cox regression models and Kaplan-Meier curves. RESULTS: CAEs (n = 161, 57.3%) often had a multi-district distribution (45.8%), while CAAs (78, 27.8%) exhibited a single-vessel pattern (80%). The co-existence of CAAs and CAE was observed in 42 cases (14.9%), and multi-vessel obstructive coronary artery disease was prevalent (55.9% overall). Rates of major adverse cardiovascular events were 14.3% in-hospital and 38.1% at a median follow-up of 18.9 (interquartile range [IQR] 6.0–39.9) months. The presence of CAAs was associated with increased major adverse cardiovascular events risk in comparison to CAE (hazard ratio [HR] = 2.26, 95% confidence interval [CI] 1.38–3.69, p = 0.001), driven by a higher hazard ratio of non-fatal myocardial infarctions (HR = 5.00, 95% CI 1.66–15.0, p = 0.004) and unplanned ischaemia-driven revascularisation in both dilated (HR = 3.23, 95% CI 1.40–7.45, p = 0.006) and non-dilated coronary artery segments (HR 3.83, 95% CI 2.08–7.07, p = 0.001). CONCLUSIONS: Overlap between obstructive and dilated coronary artery disease is frequent. Among the spectrum of dilated coronary artery disease, the presence of a CAA was associated with worse long-term outcomes. https://smw.ch/index.php/smw/article/view/3857 |
| spellingShingle | Alessandro Candreva Jessica Huwiler Diego Gallo Victor Schweiger Thomas Gilhofer Roberta Leone Michael Würdinger Maurizio Lodi Rizzini Claudio Chiastra Julia Stehli Jonathan Michel Alexander Gotschy Barbara E. Stähli Frank Ruschitzka Umberto Morbiducci Christian Templin Outcomes of coronary artery aneurysms: insights from the Coronary Artery Ectasia and Aneurysm Registry (CAESAR) Swiss Medical Weekly |
| title | Outcomes of coronary artery aneurysms: insights from the Coronary Artery Ectasia and Aneurysm Registry (CAESAR) |
| title_full | Outcomes of coronary artery aneurysms: insights from the Coronary Artery Ectasia and Aneurysm Registry (CAESAR) |
| title_fullStr | Outcomes of coronary artery aneurysms: insights from the Coronary Artery Ectasia and Aneurysm Registry (CAESAR) |
| title_full_unstemmed | Outcomes of coronary artery aneurysms: insights from the Coronary Artery Ectasia and Aneurysm Registry (CAESAR) |
| title_short | Outcomes of coronary artery aneurysms: insights from the Coronary Artery Ectasia and Aneurysm Registry (CAESAR) |
| title_sort | outcomes of coronary artery aneurysms insights from the coronary artery ectasia and aneurysm registry caesar |
| url | https://smw.ch/index.php/smw/article/view/3857 |
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