Author + information
- Mustafa Yolcu1,
- Serdar Türkmen2,
- Alper Sertçelik2,
- Emrah İpek1,
- Fatih Rıfat Ulusoy1,
- Erkan Yıldırım1,
- Barbaros Dokumacı2 and
- Talant Batyraliev2
Coronary artery ectasia (CAE) is localized or diffuse swelling of epicardial coronary arteries 1.5 times the diameter of the adjacent normal coronary segment. Atherosclerosis, congenital causes, inflammatory or connective tissue disorders are among the probable etiologies however exact etiology remains unclear. In some studies, CAE was shown to be a generalized disease affecting other vascular beds. Microalbuminuria is the subclinical increase in urinary albumin which is 30-300 mg/day in a spot urine check and is related to increased morbidity and mortality in cardiovascular disease. The aim of our study is to find out the relationship between levels of urinary microalbumin and isolated coronary artery ectasia.
58 patients with isolated CAE and 57 control subjects with normal coronary arteries (NCA) were included in the study. Previous history of myocardial infarction and percutaneous intervention, left ventricular hypertrophy, left ventricular dysfunction (EF <50%), moderate-severe valvular disease, rhythms other than sinus, congenital heart disease, chronic obstructive lung disease and/or cor pulmonale, chronic systemic illness, active infection, renal failure, neoplastic disease, antioxidant drug usage and alcohol abuse were the exclusion criteria. Midstream random urine samples were collected in the morning and microalbuminuria was determined by immunoturbidimetric method. The results were given as albumin / creatinine ratio (mg/mg). The values between 0.03 and 0.3 were defined as microalbuminuria.
The mean age was 60,55±9,77 in CAE and 57,32±8,30 in NCA groups,respectively. There was not any statistically significant difference between groups according to the cardiovascular risk factors like gender, hypertension, smoking, hyperlipidemia, diabetes mellitus and family history of CAD and the drugs used. Urinary albumin to creatinine ratio was 0,036±0,040 in isolated CAE and 0,018±0,013 in the control group, respectively, and the difference was statistically significant (p=0.002).
Microalbuminuria is a well established risk factor for cardiovascular morbidity and mortality. In our study we showed that urinary microalbumin levels were significantly increased in the isolated CAE group than the control group with normal coronary arteries (p=0.002). This result shows that there is vascular involvement at the renal glomerular level in CAE. Additionally, similar to previous studies, it can be considered that CAE is not a localized disease and is a generalized pathology which affects the entire vascular bed. It can also be postulated that increased levels of microalbumin has a significant relationship with increased cardiovascular morbidity and mortality in CAE patients. To decrease the level of microalbuminuria with any therapy can aid in reducing devastating cardiovascular end points.
|Isolated CAE||Normal||p value|
|Total cholesterol (mg/dl)||192±42||179±36||0,085|
|HDL cholesterol (mg/dl)||47±13||49±10||0,341|
|LDL cholesterol (mg/dl)||118±36||105±29||0,041|
|Uric acid (mg/dl)||5,01±1,43||4,34±1,27||0,015|
|Albumin/creatinine ratio (mg/mg)||0,036±0,040||0,018±0,013||0,002|