ABSTRACT
to determine the frequency, underlying risk factors, treatment methods, complications, and prognosis of patients with pure coronary ectasia in the study group. we conducted a retrospective analysis of all coronary angiograms performed at the catheterization laboratory of Jordan University Hospital [JUH], a tertiary referral center, between the period of December 1997 and December 2000. A 21-month follow up was performed to look for primary and secondary endpoints. The primary endpoint was the major adverse cardiac event [MACE] a composite end point of unstable angina with ECG changes, myocardial infarction or cardiac death; secondary endpoints were: recurrent chest pain, need for repeat cardiac catheterization, emergency room visits for chest pain, and hospital admission for chest pain. Data were collected from catheterization films, medical records, and a telephone questionnaire results four thousand and two hundred and five coronary angiograms were performed during the period of the study. One hundred angiograms [2.4%] showed coronary ectasia of both mixed and pure types. Sixty angiograms [1.4%] showed pure ectasia with no coronary obstructive lesions. The left anterior descending artery [LAD] was the most commonly affected vessel by ectasia [93%], followed by the right coronary artery [RCA] [64%] and the circumflex artery in 57% of the patients. The primary composite endpoint [MACE] was observed in 4 patients [6.8%] including one patient [1.7%] with none ST elevation MI [NSTEMI], one [1.7%] with ST elevation inferior wall MI, one [1.7%] with unstable angina with ECG changes, and one [1.7%] death due to pulmonary edema. The secondary endpoint of recurrent chest pain was reported by 50% of the patients at the time of follow up. Twenty seven percent presented to the emergency room during this period with chest pain, and 17% required admission to the hospital due to chest pain. Repeated cardiac catheterization was needed in 5% of patients. Therefore, over a period of 21 months, patients with ectasia were at a high risk for recurrent chest pain, but have a low risk of MI and a low mortality rate a discussion of treatment modalities and a proposed new classification for ectasia are provided. coronary ectasia remains a controversial disease in its definition, etiology, and management. A prospective randomized trial is needed to find the best therapeutic approach to its management