Author + information
- Prasad C. Gunasekaran,
- Reza Masoomi,
- Dusan Stanojevic,
- Taylor Drees,
- John Fritzlen,
- Megan Haghnegahdar,
- Matthew McCullough,
- Ashwani Mehta,
- Matthew Earnest,
- Mark Wiley,
- Eric Hockstad,
- Peter Tadros and
- Kamal Gupta
Background: Clinical presentation, natural history of coronary artery ectasia (CAE) and prognostic implications of its anatomic classification of are not well known.
Methods: We retrospectively analyzed 376 consecutive cases of CAE and angiographically categorized them using the Markis classification (Type I: Diffuse ectasia of 2-3 vessels; type II: diffuse in 1 vessel; localized in another; type III: diffuse, 1 vessel; type IV: localized/segmental ectasia). High (Markis I/II) and low grade CAE (Markis III/IV) groups were compared for clinical characteristics and outcomes.
Results: The majority of patients were white (90%) with a mean age of 70±12 years. Table 1 describes baseline/outcomes data over a mean follow up of 6.4±3.6 years. At baseline, the high grade CAE group had a higher prevalence of < TIMI 3 (slow) flow but lower prevalence of angiographic occlusive CAD. They had a higher incidence of acute coronary syndromes (ACS) on follow up and were less likely to be on optimal medical therapy (OMT).
Conclusions: The current anatomic CAE classification has prognostic significance, with higher grade CAE patients having a higher incidence of ACS on follow up despite having less extensive baseline angiographic CAD. This group had a higher prevalence of < TIMI 3 flow at baseline that may have contributed to ACS on follow up. These patients were less likely to be on OMT compared to low grade CAE, likely due to lesser extent of CAD at baseline. High grade CAE are a high risk group that merits close follow up and management.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Interventional Cardiology: PCI in Complex Patients
Abstract Category: 19. Interventional Cardiology: Complex Patients/Comorbidities
Presentation Number: 1287-192
- 2017 American College of Cardiology Foundation