Risk of cardiac arrest or ventricular tachycardia in patients with and without aneurysmal coronary artery disease
Sultan S, Ullah R, Majeed T, et al. Risk Of Cardiac Arrest Or Ventricular Tachycardia In Patients With And Without Aneursmal Coronary Artery Disease. Heart Rhythm. 2017;14(5):S120-S120. doi:10.1016/j.hrthm.2017.04.005.
Poster presented at: Heart Rhythm Scientific Sessions; May 10, 2017; Chicago, IL.
BACKGROUND: Limited information is available on the impact of coronary artery aneurysmal disease (CAN) on risk of cardiac arrest (CA) or ventricular tachycardia (VT) and overall mortality compared to patients with non-aneurysmal coronary artery diseases (CAD).
METHODS: From a large community based academic medical center patients with CAN (coronary artery diameter > 2 times adjacent normal segment) on angiography performed between 2001 to 2015 were identified and compared to 1: 1 propensity matched [age, gender, hypertension, hyperlipidemia, diabetes, smoking, previous MI, history atrial fibrillation and left ventricular ejection fraction (EF)] patients with non-aneurysmal CAD.
RESULTS: A total 269 patients were found to have CAN (mean age 65.7 ± 9.8 years, 72.6% male) and matched with 269 non-aneurysmal CAD patients. During a median follow-up of 54 months (interquartile range 25 to 106 months), the overall incidence of CA and VT was significantly lower in those with CAN compared to CAD, (composite CA and VT 11.9% vs 22.6%; HR: 0.63, 95% CI: 0.41-0.96; p-value: 0.033, Fig A), however the overall mortality was not significantly different (33% vs 28%, p=0.15). The stratified analysis showed that male, non-smokers, left ventricular ejection fraction greater than 50% and no history of renal insufficiency, cardiomyopathy, heart failure and diabetes subgroups have significantly less composite outcome in aneurysmal CAD as compared to non-aneurysmal CAD (Fig B).
CONCLUSION: Patients with aneurysmal coronary artery disease are at a lower risk of CA and VT when compared to those with non-aneurysmal CAD.