Incidence, Clinical Presentation and Angiographic Findings among Patients with Coronary Artery Ectasia in Gaza

Background: Coronary artery ectasia (CAE) is a rare form of aneurysmal coronary heart disease. This condition increases risk of ischemia that leaded to stable angina pectoris and also acute coronary syndrome. Objective: To evaluate the incidence of CAE and to analyze clinical and angiographic characteristics among patients with symptomatic coronary artery disease. Methods: Retrospective trial of diagnostic coronary angiography which was performed at Alshifa hospital in Gaza, included all patients with coronary heart disease and underwent diagnostic coronary angiography from March 2014 to March 2023. We evaluate the incidence, clinical presentation and angiographic findings of patients with symptomatic coronary ectasia. Results: Of the 12,534 angiograms analyzed, CAE was found in 539 patients, an incidence of 4.3%. The mean age was 59.2 ± 11.7 years, and male gender predominate 81.8%. A 285 (52.9%) of patients found to have single ectatic vessel at their angiographic results. In two vessels 120 patients (22.3%), in three vessels 95 patients (17.6%) and in three vessel plus left main in 39 patients (7.2%). 70.9% angiograms showed pure ectasia without associated significant stenotic lesions in the same vessel. The right coronary artery (RCA) was the commonest affected vessel by ectasia. The most common presentation of patients is non ST segment elevation acute coronary syndrome. Conclusion: The incidence of coronary ectasia was 4.3%. Non ST segment elevation acute coronary syndrome was the most common clinical presenting. Only 30% of patients have additionally significant coronary artery stenosis. The majority of patients had single vessel involvement and right coronary artery was the most common involved vessel. Despite a dapper understanding of CAE in last years, there are still come critical issues about optimal treatment. Large multicenter randomized control trials are recommended to guide the clinician in the management of this complex sitting of patients.