Coronary artery aneurysms: A 25-patient study

Coronary artery aneurysm is a rare disorder, characterized by abnormal dila tation of a localized portion or diffuse segments of the coronary artery. W e studied clinical demographics, catheterization findings, and clinical out comes in an Asian patient cohort with documented coronary artery aneurysms. Compared to a Caucasian adult population, our patient cohort had a lower i ncidence of coronary artery aneurysm (0.25% vs, 2.6%), and more patients wi th nonobstructive coronary artery aneurysms (70%); age, gender, and coronar y distribution were comparable. The initial presentation of myocardial infa rction occurred in five patients (5/17, 30%) with nonobstructive coronary a rtery aneurysms; however, none who were receiving preventive medications co nsisting of anticoagulant and antiplatelet agents subsequently developed my ocardial infarction. We conclude that the incidence of coronary artery aneu rysms with or without associated significant coronary stenosis seems to be lower in the Asian population. In contrast, the incidence of nonobstructive coronary artery aneurysms is considerably high and should not be thought o f as a relatively benign disease entity if not treated with preventive medi cations. Rheumatoid arthritis-related vasculitis might be a cause of corona ry artery aneurysm. Surgical intervention is based on the severity of coron ary artery stenosis. The result of medical treatment has been compatible wi th long-term survival. (C) 1999 Wiley-Liss, Inc.