Iván J Núñez-Gil1, Enrico Cerrato2, Mario Bollati3, Luis Nombela-Franco4, Belén Terol5, Emilio Alfonso-Rodríguez6, Santiago J Camacho Freire7, Pedro A Villablanca8, Ignacio J Amat Santos9, José M de la Torre Hernández10, Isaac Pascual11, Christoph Liebetrau12, Benjamín Camacho13, Marco Pavani14, Juan Albistur15, Roberto Adriano Latini16, Ferdinando Varbella2, Víctor Alfonso Jiménez-Díaz17, Davide Piraino18, Massimo Mancone19, Fernando Alfonso20, José Antonio Linares21, Ramón Rodríguez-Olivares22, Jesús M Jiménez Mazuecos23, Jorge Palazuelos Molinero24, Alejandro Sánchez-Grande Flecha25, Joan Antoni Gomez-Hospital26, Alfonso Ielasi27, Íñigo Lozano28, Pierluigi Omedè29, Rodrigo Bagur30, Fabrizio Ugo31, Massimo Medda32, Boshra F Louka33, Petr Kala34, Javier Escaned35, Daniel Bautista36, Gisela Feltes4, Pablo Salinas4, Mohamad Alkhouli37, Carlos Macaya35, Antonio Fernández-Ortiz38. 1. Cardiovascular Institute, Hospital Clínico San Carlos, Madrid, Spain; Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain. Electronic address: ibnsky@yahoo.es. 2. Interventional Cardiology, Infermi Hospital, Rivoli, Turin, Italy. 3. Interventional Cardiology, Policlinico San Donato, Milan, Italy. 4. Cardiovascular Institute, Hospital Clínico San Carlos, Madrid, Spain. 5. Cardiology Department, Hospital Severo Ochoa, Leganés, Spain. 6. Instituto de Cardiología y Cirugía Cardiovascular, La Habana, Cuba. 7. Interventional Cardiology, Hospital Juan Ramón Jiménez, Huelva, Spain. 8. Interventional Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, USA. 9. CIBERCV, Interventional Cardiology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain. 10. Cardiology Department, Hospital U. Marques de Valdecilla, IDIVAL, Santander, Spain. 11. Department of Cardiology, Hospital Universitario Central de Asturias, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias, ISPA, Oviedo, Spain; University of Oviedo, Oviedo, Spain. 12. Kerckhoff Heart and Thorax Center, Department of Cardiology, Bad Nauheim, Germany; DZHK (German Centre for Cardiovascular Research), partner site Rhein-Main, Frankfurt am Main, Germany. 13. Interventional Cardiology, Hospital Arnau de Vilanova, Lérida, Spain. 14. Cardiology, Città della Salute e della Scienza, Molinnette II, Torino, Italy. 15. Cardiology, Hospital de Clínicas Dr, Manuel Quintela, Montevideo, Uruguay. 16. Cardiologia Interventistica, ASST Fatebenefratelli-Sacco Milan, Italy. 17. Interventional Cardiology, Hospital Álvaro Cunqueiro, Vigo, Spain. 18. UO di Cardiologia Interventistica ed Emodinamica, Azienda Ospedaliera Universitaria Policlinico "P,Giaccone" Palermo, Italy. 19. Is Sapienza University of Rome, Policlinico Umberto I. Department of Cardiovascular, Respiratory, Neurological, Anaesthesiology and Geriatric Sciences. 20. Cardiology Department, Hospital Universitario de La Princesa, Madrid, Spain. 21. Interventional Cardiology, H Lozano Blesa, Zaragoza, Spain. 22. Interventional Cardiology, Utrecht Medisch Centrum, Utrecht, the Netherlands. 23. Interventional Cardiology, H General Universitario de Albacete, Albacete, Spain. 24. Interventional Cardiology, Hospital central de la Defensa "Gomez Ulla", Madrid, Spain. 25. Interventional Cardiology, H Universitario de Canarias, San Cristobal de la Laguna, Spain. 26. Interventional Cardiology, Hospital de Bellvitge, Barcelona, Spain. 27. Cardiology Division, ASST Bergamo Est, Bolognini Hospital Seriate, Italy. 28. Interventional Cardiology, Hospital de Cabueñes, Gijon, Spain. 29. Cardiology, Città della Salute e della Scienza, Molinnette I, Torino, Italy. 30. Interventional Cardiology, University Hospital, London Health Sciences Centre, London, Ontario, Canada. 31. Interventional Cardiology, H San Giovanni Bosco, Turin, Italy. 32. Interventional Cardiology Unit, Istituto Clinico Sant'Ambrogio, Milan, Italy. 33. Division of Cardiovascular Diseases, Mayo Clinic Arizona, USA. 34. Department of Internal Medicine and Cardiology, University Hospital Brno and Medical Faculty of Masaryk University, Brno, Czech Republic. 35. Cardiovascular Institute, Hospital Clínico San Carlos, Madrid, Spain; Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain. 36. Cardiology, Instituto dominicano de Cardiología, Santo Domingo, Dominican Republic. 37. Cardiology, West Virginia University Heart and Vascular Institute, Morgantown, WV, United States of America. 38. Cardiovascular Institute, Hospital Clínico San Carlos, Madrid, Spain; Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.
Abstract
BACKGROUND: Coronary Aneurysms are a focal dilatation of an artery segment >1.5-fold the normal size of adjacent segments. Although some series have suggested a prevalence of 0.3-12%, data are lacking. In addition, they are not mentioned in practice guidelines. Our aim was investigate its prevalence, management and long-term outcomes. METHODS AND RESULTS: The coronary artery aneurysm registry (CAAR) involved 32 hospitals across 9 countries in America and Europe. We reviewed 436,467 consecutive angiograms performed over the period 2004-2016. Finally, 1565 patients were recruited. Aneurysm global prevalence was 0.35%. Most patients were male (78.5%) with a mean age of 65 years and frequent cardiovascular risk factors. The main indication for angiogram was an acute coronary syndrome, 966 cases. The number of aneurisms was ≤2 per patient in 95.8% of the cases, mostly saccular, most frequently found in the left anterior descending and with numbers proportional with coronary stenosis. Aortopathies were related with more aneurysms too. Most patients received any revascularization procedure (69%), commonly percutaneous (53%). After a median follow-up of 37.2 months, 485 suffered a combined event (MACE) and 240 died. Without major differences comparing CABG vs PCI, MACE and death were more frequent in patients who received bare metal stents. CONCLUSIONS: Coronary artery aneurysms are not uncommon. Usually, they are associated with coronary stenosis and high cardiovascular risk. Antiplatelet therapy seems reasonable and a percutaneous approach is safe and effective.
BACKGROUND:Coronary Aneurysms are a focal dilatation of an artery segment >1.5-fold the normal size of adjacent segments. Although some series have suggested a prevalence of 0.3-12%, data are lacking. In addition, they are not mentioned in practice guidelines. Our aim was investigate its prevalence, management and long-term outcomes. METHODS AND RESULTS: The coronary artery aneurysm registry (CAAR) involved 32 hospitals across 9 countries in America and Europe. We reviewed 436,467 consecutive angiograms performed over the period 2004-2016. Finally, 1565 patients were recruited. Aneurysm global prevalence was 0.35%. Most patients were male (78.5%) with a mean age of 65 years and frequent cardiovascular risk factors. The main indication for angiogram was an acute coronary syndrome, 966 cases. The number of aneurisms was ≤2 per patient in 95.8% of the cases, mostly saccular, most frequently found in the left anterior descending and with numbers proportional with coronary stenosis. Aortopathies were related with more aneurysms too. Most patients received any revascularization procedure (69%), commonly percutaneous (53%). After a median follow-up of 37.2 months, 485 suffered a combined event (MACE) and 240 died. Without major differences comparing CABG vs PCI, MACE and death were more frequent in patients who received bare metal stents. CONCLUSIONS:Coronary artery aneurysms are not uncommon. Usually, they are associated with coronary stenosis and high cardiovascular risk. Antiplatelet therapy seems reasonable and a percutaneous approach is safe and effective.
Authors: Juan Hernando Del Portillo; Boris Miguel Hernandez; María Angélica Bazurto; Dario Echeverri; Jaime Cabrales Journal: J Clin Sleep Med Date: 2022-02-01 Impact factor: 4.062
Authors: F Arslan; I J Núñez-Gil; R Rodríguez-Olivares; E Cerrato; M Bollati; L Nombela-Franco; B Terol; E Alfonso-Rodríguez; S J Camacho Freire; P A Villablanca; I J Amat Santos; J M De la Torre Hernández; I Pascual; C Liebetrau; M Alkhouli; A Fernández-Ortiz Journal: Neth Heart J Date: 2021-12-15 Impact factor: 2.854
Authors: Luca Esposito; Marco Di Maio; Angelo Silverio; Francesco Paolo Cancro; Michele Bellino; Tiziana Attisano; Fabio Felice Tarantino; Giovanni Esposito; Carmine Vecchione; Gennaro Galasso; Cesare Baldi Journal: Front Cardiovasc Med Date: 2022-02-04