TY - JOUR
T1 - Coronary artery aneurysms, insights from the international coronary artery aneurysm registry (CAAR)
AU - CAAR investigators
AU - Núñez-Gil, Iván J.
AU - Cerrato, Enrico
AU - Bollati, Mario
AU - Nombela-Franco, Luis
AU - Terol, Belén
AU - Alfonso-Rodríguez, Emilio
AU - Camacho Freire, Santiago J.
AU - Villablanca, Pedro A.
AU - Amat Santos, Ignacio J.
AU - de la Torre Hernández, José M.
AU - Pascual, Isaac
AU - Liebetrau, Christoph
AU - Camacho, Benjamín
AU - Pavani, Marco
AU - Albistur, Juan
AU - Latini, Roberto Adriano
AU - Varbella, Ferdinando
AU - Jiménez-Díaz, Víctor Alfonso
AU - Piraino, Davide
AU - Mancone, Massimo
AU - Alfonso, Fernando
AU - Linares, José Antonio
AU - Rodríguez-Olivares, Ramón
AU - Jiménez Mazuecos, Jesús M.
AU - Palazuelos Molinero, Jorge
AU - Sánchez-Grande Flecha, Alejandro
AU - Gomez-Hospital, Joan Antoni
AU - Ielasi, Alfonso
AU - Lozano, Íñigo
AU - Omedè, Pierluigi
AU - Bagur, Rodrigo
AU - Ugo, Fabrizio
AU - Medda, Massimo
AU - Louka, Boshra F.
AU - Kala, Petr
AU - Escaned, Javier
AU - Bautista, Daniel
AU - Feltes, Gisela
AU - Salinas, Pablo
AU - Alkhouli, Mohamad
AU - Macaya, Carlos
AU - Fernández-Ortiz, Antonio
AU - Benítez, Piter Martínez
AU - Menchero, Antonio Gomez
AU - Jimenez, Javier León
AU - Fernandez, José Francisco Díaz
AU - Makkiya, Mohammed
AU - Bulcha, Nurilign
AU - Yang, Eric
AU - Ramakrishna, Harish
N1 - Publisher Copyright:
© 2019 Elsevier B.V.
PY - 2020/1/15
Y1 - 2020/1/15
N2 - 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.
AB - 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.
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U2 - 10.1016/j.ijcard.2019.05.067
DO - 10.1016/j.ijcard.2019.05.067
M3 - Article
C2 - 31378382
AN - SCOPUS:85069970254
SN - 0167-5273
VL - 299
SP - 49
EP - 55
JO - International Journal of Cardiology
JF - International Journal of Cardiology
ER -