Coronary Artery Aneurysms: Analysis of Comorbidities from the National Inpatient Sample

Abstract

Introduction Coronary artery aneurysms (CAA) are not commonly seen in the general population, with an incidence of approximately 0.37% to 2.53%. Patients are typically asymptomatic but symptomatic presentation varies from dyspnea and angina to myocardial infarction or even sudden cardiac death. Methods We conducted a retrospective analysis using the National Inpatient Sample Healthcare Cost and Utilization Project (NIS-HCUP) database to query individuals with the diagnosis of CAA with the International Classification of Disease (ICD) code 414.11 in all discharge diagnoses for the years 2006-2014. History of Kawasaki disease was determined by ICD code 446.1. Results From 2006 to 2014, there were 23,033 patients identified with CAA, correlating to approximately one case per 10,000 patients or an incidence of close to 0.01%. Of this, 1,405 or approximately 6.1% of these patients had Kawasaki disease. The mortality rate of CAA was 1.79%. In terms of demographics, Caucasians were the most likely to develop CAA, with 73.8% of cases. The mean age was 61.2 years, with a mean length of stay of 5.1 days. The average cost of admission was $70892. The presence of perivascular disease (15.5% vs 4.5% p<0.05), hypertension (66.1% vs 39.1% p<0.05), chronic lung disease (20.2% vs 15.1% p<0.05), diabetes (21.7% vs 15% p<0.05), renal failure (11% vs 8.8% p<0.05), coagulopathy (6.2% vs 3.4% p<0.05), and obesity (13.1% vs 8.2% p<0.05) were all risk factors for CAA as compared to those without. It was noted that weight loss (3.28% vs 1.91% p<0.05), electrolyte abnormalities (18.2% vs 15.5% p<0.05), and blood loss (2.1% vs 0.9% p<0.05) were protective of CAA. Conclusion CAA risk factors appear to be similar to those of coronary artery disease risk factors, with hypertension, diabetes, perivascular disease, and renal failure. Additionally, obesity was noted to be a risk factor but weight loss appeared to be protective. Interestingly, Kawasaki disease was seen at almost similar rates as these cardiac risk factors. The incidence of CAA we found, of almost 0.01%, is much less than in the quoted literature, however, previous studies did not have as many cases as our study.

Anti-inflammatory effects of rosuvastatin treatment on coronary artery ectasia patients of different age groups

“…It is a relatively rare coronary artery abnormality (prevalence < 5%) among coronary artery diseases [2]. The increased prevalence of CAE in recent years has resulted in a greater focus on the incidence and factors influencing CAE; estimates of the prevalence of CAE have varied from 0.3 to 4.7% [3]. Nevertheless, etiopathogenetic mechanism of CAE is not yet completely known, although it may be related to systemic inflammation, stimulated nitric oxide production, coronary balloon angioplasty, extracellular matrix degradation, dyslipidemia, nodular polyarteritis, Kawasaki syndrome, and even genetic predisposition [4,5].…”

Anti-inflammatory effects of rosuvastatin treatment in coronary artery ectasia patients in different age groups

“…CAE is characteristically de ned as a dilated coronary artery segment whose diameter is at least 1.5-times that of the adjacent normal coronary lumen [1] and is a relatively rare coronary artery abnormality (incidence <5%) among coronary artery diseases [2]. The increased prevalence of CAE in recent years has resulted in a greater focus on the incidence and factors in uencing CAE [3];estimates of the incidence of coronary ectasia have varied from 0.3% to 4.7%. However, the etiopathogenetic mechanism of CAE is not yet completely known, although it may be related to systemic in ammation, stimulated nitric oxide production, coronary balloon angioplasty, nodular polyarteritis, and Kawasaki syndrome [4,5].…”

Assessment of the Relationship Between C-Reactive Protein-to-Albumin Ratio and the Presence and Severity of Isolated Coronary Artery Ectasia

“…17,18 Patients with CAE do not differ in terms of gender, age, or presence of concomitant diseases from patients with obstructive CAD. 19 The mortality rate in patients with CAE after 5 years of follow-up is similar to the mortality rate of patients with 3-vessel disease who underwent medical treatment. 20 Isolated CAE has become an important research topic due to its high mortality rate.…”