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Long-Term Prognosis of Coronary Aneurysms: Insights of CAAR, an International Registry
I. Sánchez-Sánchez, E. Cerrato, M. Bollati, C. Espejo-Paeres, L. Nombela-Franco, E. Alfonso-Rodríguez, SJ. Camacho-Freire, PA. Villablanca, IJ. Amat-Santos, JM. De la Torre Hernández, I. Pascual, C. Liebetrau, B. Camacho, M. Pavani, J. Albistur,...
Language English Country United States
Document type Journal Article, Multicenter Study, Observational Study
- MeSH
- Time Factors MeSH
- Risk Assessment MeSH
- Cohort Studies MeSH
- Coronary Aneurysm * diagnostic imaging mortality therapy MeSH
- Middle Aged MeSH
- Humans MeSH
- Registries * MeSH
- Risk Factors MeSH
- Aged MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Observational Study MeSH
- Geographicals
- Europe MeSH
- North America MeSH
BACKGROUND: Limited data are available to guide the management of coronary artery aneurysms (CAAs). OBJECTIVES: The authors sought to define the clinical characteristics, identify variables that predict outcomes, and provide long-term data on CAAs. METHODS: We describe outcomes from 1,729 consecutive patients with CAAs included in an ambispective international registry (CAAR [Coronary Artery Aneurysm Registry]; NCT02563626) involving 33 hospitals across 9 countries in America and Europe. RESULTS: Patients were predominantly male (78.6%; 1,359/1,729) with a mean age of 66 years. Classic cardiovascular risk factors were common, as well as coronary artery disease (85.8%; 1,484/1,729), peripheral vascular disease (10.9%; 188/1,729), and chronic kidney disease (8.0%; 138/1,729). The median number of aneurysms per patient was 1.0 (Q1-Q3: 1.0-1.0), with the most affected territory being the left anterior descending artery (49.6%; 857/1,729). The majority underwent any revascularization procedure (68.5%; 1,184/1,729), mainly percutaneous coronary intervention (50.7%; 877/1,729), and were discharged on dual antiplatelet therapy (65.6%; 1,134/1,729). After a median follow-up of 44.8 months (Q1-Q3: 14.9-88.1), 379 died (21.9%), and 641 (37.1%) developed a major adverse cardiovascular event (MACE) (all-cause death, heart failure, unstable angina, and reinfarction). In a multivariable analysis, age (HR: 1.03; 95% CI: 1.02-1.04; P < 0.001), diabetes mellitus (HR: 1.47; 95% CI: 1.23-1.75; P < 0.001), renal insufficiency (HR: 1.53; 95% CI: 1.19-1.96; P = 0.010), peripheral vessel disease (HR: 1.43; 95% CI: 1.13-1.82; P = 0.003), reduced left ventricular ejection fraction (HR: 0.98; 95% CI: 0.98-0.99; P < 0.001), acute indication for the index coronary angiography (HR: 1.30; 95% CI: 1.08-1.55; P = 0.005), and the number of coronary vessels presenting severe stenosis (HR: 1.11; 95% CI: 1.02-1.20; P = 0.015) were independent predictors of MACEs. Remarkably, only 37 patients presented with local aneurysm complications during follow-up. CONCLUSIONS: The long-term prognosis of CAAs is not favorable, with MACEs associated with the underlying risk factor profile for atherosclerotic heart disease.
Cardiology Città della Salute e della Scienza Molinnette 1 Torino Italy
Cardiology Department Hospital Álvaro Cunqueiro University Hospital of Vigo Vigo Pontevedra Spain
Cardiology Department Hospital Central de Asturias Oviedo Spain
Cardiology Department Hospital Fundación Jiménez Diaz Madrid Spain
Cardiology Department Hospital Universitario Marqués de Valdecilla IDIVAL Santander Spain
Cardiology Hospital Universitario de Torrejón Madrid Spain
Cardiology Instituto Dominicano de Cardiología Santo Domingo Dominican Republic
Cardiovascular Research Group Galicia Sur Health Research Institute SERGAS UVIGO Vigo Spain
Centro Nacional de Investigaciones Cardiovasculares Madrid Spain
CIBERCV Interventional Cardiology Hospital Clínico Universitario de Valladolid Valladolid Spain
Cuban Society of Basic Biomedical Sciences Havana Cuba
Department of Cardiology Mayo Clinic Rochester Minnesota USA
Department of Internal Medicine and Cardiology University Hospital Brno Brno Czech Republic
DZHK Partner Site Rhein Main Frankfurt am Main Germany
Faculty of Biomedical and Health Sciences Universidad Europea de Madrid Madrid Spain
Faculty of Medicine Universidad Complutense de Madrid Madrid Spain
Interventional Cardiology H General Universitario de Albacete Albacete Spain
Interventional Cardiology H Lozano Blesa Zaragoza Spain
Interventional Cardiology H Universitario de Canarias San Cristobal de la Laguna Spain
Interventional Cardiology Henry Ford Hospital Detroit Michigan USA
Interventional Cardiology Hospital Arnau de Vilanova Lérida Spain
Interventional Cardiology Hospital Clínico San Carlos IdISSC Madrid Spain
Interventional Cardiology Hospital de Bellvitge Barcelona Spain
Interventional Cardiology Hospital de Cabueñes Gijón Spain
Interventional Cardiology Hospital Juan Ramón Jiménez Huelva Spain
Interventional Cardiology Hospital La Luz Madrid Spain
Interventional Cardiology Ospedale Maggiore Lodi Italy
Interventional Cardiology Unit San Luca Hospital Milan Italy
Interventional Cardiology Unit Sant'Andrea Hospital Vercelli Italy
Interventional Cardiology Utrecht Medisch Centrum Utrecht the Netherlands
Interventional Unit San Luigi Gonzaga University Hospital Orbassano Turin Italy
Kerckhoff Heart and Thorax Center Department of Cardiology Bad Nauheim Germany
Medical Faculty of Masaryk University Brno Czech Republic
Rivoli Infermi Hospital Rivoli Turin Italy
U O Cardiologia Ospedaliera IRCCS Ospedale Galeazzi Sant'Ambrogio Milan Italy
Unidad Académica de Cardiología Hospital de Clínicas Dr Manuel Quintela Montevideo Uruguay
References provided by Crossref.org
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