Abstract：
Coronary artery ectasia (CAE) is defined as local or generalized aneurysmal dilatation of the coronary arteries. CAE likely represents an exaggerated form of excessive vascular wall remodeling in different clinical settings such as atherosclerosis, vasculitides, connective tissue disorders, hereditary collagen defects, bacterial infections, and congenital malformations. In the present case-control study, we investigated whether the incidental finding of CAE in patients who undergo coronary angiography is associated with presence of autoimmune reactivity. From 2019 to 2022, we identified all consecutive patients with CAE (n = 319) on elective or emergency coronary angiography (n = 7,458). We furthermore included 90 patients with nonectatic coronary arteries as a control group. Antinuclear antibody (ANA) titer was measured in both groups using the indirect immunofluorescence method from peripheral blood samples. The prevalence of CAE in our study cohort was 4.3%. Among patients with CAE (n = 319), presence of positive Antinuclear antibody (ANA) titer was identified in 128 patients (40%). Only 18 patients (20%) from the control group had positive ANA titer. There was a statistically significant greater percentage of patients with positive ANA titer among patients with CAE than among controls (chi-square = 12.39; p <0.001), with an odds ratio of 2.68. Among patients with CAE, there is an increased prevalence of positive ANA titer, suggesting an underlying autoimmune disease. Screening for autoimmune reactivity could be a reasonable diagnostic strategy in patients who undergo coronary angiography with an incidental finding of coronary ectasia because the number needed to screen for positive ANA titer in this subgroup of patients is only 5.
摘要：
冠状动脉扩张症（CAE）定义为冠状动脉的局部或广泛性动脉瘤扩张。CAE可能代表了在不同的临床设置，如动脉粥样硬化，过度血管壁重塑的夸张形式。血管炎,结缔组织疾病,遗传性胶原缺陷，细菌感染,先天性畸形.在本病例对照研究中，我们调查了冠状动脉造影患者中偶然发现的CAE是否与自身免疫反应性相关.从2019年到2022年，我们在选择性或紧急冠状动脉造影中确定了所有连续的CAE患者（n=319）（n=7,458）。我们还纳入了90例非扩张性冠状动脉患者作为对照组。使用间接免疫荧光方法从外周血样品中测量两组的抗核抗体（ANA）滴度。在我们的研究队列中，CAE的患病率为4.3%。在CAE患者中（n=319），在128例患者(40%)中发现抗核抗体(ANA)滴度阳性.对照组中只有18名患者（20％）的ANA滴度呈阳性。在CAE患者中，ANA滴度阳性患者的百分比高于对照组（卡方=12.39；p<0.001），赔率比为2.68。在CAE患者中，ANA滴度阳性的患病率增加，提示潜在的自身免疫性疾病。在进行冠状动脉造影并偶然发现冠状动脉扩张的患者中，筛查自身免疫反应性可能是合理的诊断策略，因为在该亚组患者中筛查ANA滴度阳性所需的人数仅为5。
