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Anticoagulant and Antiplatelet Treatment Effects on the Incidence of Major Cardiovascular Events in Patients With Coronary Artery Ectasia: An Updated Systematic Review Publisher Pubmed



Amirpour A1 ; Zavar R1 ; Danesh M1 ; Mirbod SM2 ; Zaker E3 ; Moslemi F4 ; Amini Z4 ; Sadeghi M1
Authors
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Authors Affiliations
  1. 1. Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Department of Cardiology, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  4. 4. Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

Source: Indian Heart Journal Published:2024


Abstract

Introduction: Coronary artery ectasia (CAE), widenings in sections of the arteries, is a rare condition found in up to 3–5% of angiography cases. Sometimes recurrence of major adverse cardiac events (MACE) has been reported in the CAE subjects. The present systematic review aims to collect and summarize reports on whether the use of anticoagulants in addition to single antiplatelet/dual antiplatelet therapy (SAPT/DAPT) in CAE patients with significant occlusion/heavy thrombus is efficient and safe in decreasing the incidence/recurrence of MACE. Material and methods: A systematically comprehensive search was performed covering PubMed, Scopus, ISI Web of Science, and Google Scholar databases. Results: Twenty-five studies were found including 20 case reports, four case series, and one randomized clinical trial. Of 20 case reports 15 were male (75 %), and five were female (25 %). Of the four the case series, all showed positive outcomes after DAPT plus anticoagulant in more than 50 % of patients; two took only DAPT and 13 took anticoagulant ± DAPT, and five compared both. Cases received DAPT only experienced recurrences of MACE. The other cases were uneventful with less MACE and better outcomes after the use of anticoagulant ± DAPT. Results of these case-series included 457 CAE patients showed that more than 80 % of subjects were male, and in all studies tailored pharmacological interventions, including antiplatelet and anticoagulant (warfarin) therapies, resulted in less MACE and mortality. Conclusion: It can be concluded that antiplatelet (SAPT/DAPT) must be applied in combination with anticoagulants to provide more efficient protection against MACE in CAE patients. However, further high-quality randomized clinical trials are needed to confirm the results. © 2024
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