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Plasma levels of nitric oxide (NO) are decreased in patients with atherosclerosis and in those with risk factors for atherosclerosis. In these patients, reduction of the serum nitric oxide levels are correlated with the severity of endothelial dysfunction and atherosclerosis. Endothelial dysfunction and diffuse atherosclerosis have been proposed for the etiology of coronary artery ectasia (CAE). The aim of this study was to evaluate the relationship between CAE and serum nitric oxide levels.
The transient and volatile nature of NO makes it unsuitable for most convenient detection methods, however, the plasma levels of nitrite plus nitrate (NOx),two breakdown products, nitrate (NO3) and nitrite (NO2) can be detected by photometric methods.We measured plasma levels of NO by photometric methods in 40 patients with isolated coronary artery ectasia and 20 patients with normal coronary arteries as a control group (mean age 58.2+11.7 vs 57.1+12.5, resp. p=0.74).
Plasma nitric oxide concentrations were significantly lower in the CAE group than control group (41.8±22.4 vs 77.3±21.9 μmol/l, p<0.001).We observed statistically significant correlation between decreased level of serum nitric oxide and the presence of isolated coronary artery ectasia (r= -0.61. p<0.001). In multivariate analysis serum NO level is an unique independent predictor of presence of coronary artery ectasia (OR=0.93; 95% confidence interval, 0.89-0.97, p<0.001).
We found that serum NO level is decreased in patients with isolated coronary artery ectasia. These findings suggest that decreased NO level may be associated with endothelial dysfunction leading to the development of coronary artery ectasia.