Coronary artery aneurysms, insights from the international coronary artery aneurysm registry (CAAR)

CAAR investigators

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
JournalInternational Journal of Cardiology
DOIs
StateAccepted/In press - Jan 1 2019

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Coronary Aneurysm
Registries
Coronary Vessels
Coronary Stenosis
Aneurysm
Angiography
Acute Coronary Syndrome
Practice Guidelines
Stents
Dilatation
Arteries
Metals

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Coronary artery aneurysms, insights from the international coronary artery aneurysm registry (CAAR). / CAAR investigators.

In: International Journal of Cardiology, 01.01.2019.

Research output: Contribution to journalArticle

@article{f53236891fe74af38bbf5350ea2e99c5,
title = "Coronary artery aneurysms, insights from the international coronary artery aneurysm registry (CAAR)",
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.",
author = "{CAAR investigators} and N{\'u}{\~n}ez-Gil, {Iv{\'a}n J.} and Enrico Cerrato and M. Bollati and Luis Nombela-Franco and Bel{\'e}n Terol and Emilio Alfonso-Rodr{\'i}guez and {Camacho Freire}, {Santiago J.} and Villablanca, {Pedro A.} and {Amat Santos}, {Ignacio J.} and {de la Torre Hern{\'a}ndez}, {Jos{\'e} M.} and I. Pascual and Christoph Liebetrau and Benjam{\'i}n Camacho and M. Pavani and Juan Albistur and Latini, {Roberto Adriano} and Ferdinando Varbella and Jim{\'e}nez-D{\'i}az, {V{\'i}ctor Alfonso} and Davide Piraino and Massimo Mancone and Fernando Alfonso and Linares, {Jos{\'e} Antonio} and Ram{\'o}n Rodr{\'i}guez-Olivares and {Jim{\'e}nez Mazuecos}, {Jes{\'u}s M.} and {Palazuelos Molinero}, J. and {S{\'a}nchez-Grande Flecha}, Alejandro and Gomez-Hospital, {Joan Antoni} and Alfonso Ielasi and {\'I}{\~n}igo Lozano and Pierluigi Omed{\`e} and Rodrigo Bagur and Fabrizio Ugo and Massimo Medda and Louka, {Boshra F.} and Petr Kala and Javier Escaned and Daniel Bautista and Gisela Feltes and P. Salinas and Mohamad Alkhouli and Carlos Macaya and Antonio Fern{\'a}ndez-Ortiz and Ben{\'i}tez, {Piter Mart{\'i}nez} and Menchero, {Antonio Gomez} and Jimenez, {Javier Le{\'o}n} and Fernandez, {Jos{\'e} Francisco D{\'i}az} and Mohammed Makkiya and Nurilign Bulcha and Sarabjeet Suri and Harish Ramakrishna",
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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, M.

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, I.

AU - Liebetrau, Christoph

AU - Camacho, Benjamín

AU - Pavani, M.

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, J.

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, P.

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 - Suri, Sarabjeet

AU - Ramakrishna, Harish

PY - 2019/1/1

Y1 - 2019/1/1

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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DO - 10.1016/j.ijcard.2019.05.067

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JO - International Journal of Cardiology

JF - International Journal of Cardiology

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