Analysis of Traditional Risk Factors of Atherosclerosis and Novel Risk Markers of Inflammation in Coronary Ectasia Can We Solve The Enigma ??

Abstract Background: Coronary artery ectasia(CAE) is speculated as a variant of atherosclerosis. The pathogenesis of CAE remains an enigma. Here in our study, we aimed to elucidate the role of traditional risk factors of atherosclerosis and inflammation in coronary ectasia.Methods and Results: This comparative study was carried in a tertiary hospital in South India.Patients with coronary artery ectasia and obstructive coronary artery disease were included as cases and controls . Traditional risk factors of atherosclerosis and risk markers of inflammation (neutrophil-lymphocyte ratio(NLR), red cell distribution width (RDW), mean platelet volume (MPV) )were evaluated and comparative analysis was done. Coronary ectasia was observed in 5.6%(n=136)of the study population. Among those with ectasia,112(82.4%) patients were having significant obstructive CAD (mixed group), isolated ectasia observed in24 (17.6%)patients. Isolated ectasia had an inverse association with diabetes mellitus and male:female ratio of (7:1). DM was seen only in 25% of isolated ectasia groups compared to 42.9%, 47.4% among mixed and obstructive CAD groups respectively (p < 0.05). Traditional risk factors were not significantly different between the mixed group and obstructive CAD group. Inflammatory markers were significantly higher among the both ectasia group compared to obstructive CAD group NLR: 3.98±0.89, 3.58±0.56, 2.82±0.60 p <0.001. RDW:12.59±0.60, 12.29±0.85,12.02±0.70, p<0.005. MPV was elevated in all three groups but not much different among groups.Conclusion: Coronary ectasia commonly seen in association with obstructive CAD, the prevalence of traditional risk factors of atherosclerosis is similar between CAE+CAD, obstructive CAD group suggest atherosclerosis as the underlying pathophysiology. Elevated markers of inflammation suggest overlying inflammation on atherosclerosis to be the contributor of ectasia.