ABSTRACT
Coronary artery ectasia [CAE] is an uncommon angiographic finding, the prevalence in most series ranges from 1.2% to 5.3%. CAE was defined as arterial segment with a diameter of at least 1.5 times the diameter of adjacent normal coronary artery segment. Atherosclerosis is the most common cause of CAE and there is a high association of CAE with stenotic coronary artery disease. CAE is not an innocent condition even in the patients with pure ectasia without stenosis. It may present by chronic stable angina pectoris, unstable angina, myocardial infarction and heart failure. Immune cells appear to be critical in development of atherosclerosis. High levels of neopterin were found in patients with chronic stable angina pectoris and acute coronary syndromes. Correlation of serum neopterin levels to the presence of CAE in patients with stable coronary artery disease. Forty patients referred to cardiac catheterization unit for evaluation of typical stable angina pectoris, were divided into three groups: Group A [15 patients] of pure ectasia, Group B [15 patients] of CAE associated with stenosis and Group C [10 patients] of stenotic lesions only. Each patient in the three groups was subjected to coronary angiography, and measurement of serum neopterin level by ELISA technique. Neopterin levels were elevated in the three studied groups but were significantly higher in patients with two and three vessels lesions than in patients with one vessel lesion. Also neopterin levels were significantly higher in ectasia with slow flow than in ectasia without slow flow. Inflammation seems to play a major role in the etiology of CAE as well as coronary artery stenosis. Neopterin level is related to the severity of the disease. Also it seems that there is more activation of the immune system in ectasia with slow flow than in ectasia without slow flow as neopterin level was higher in ectasia with slow flow than ectasia without slow flow