Abstract：
BACKGROUND: 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.
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.
CONCLUSIONS: 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.
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.
CONCLUSIONS: 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.
摘要：
背景：冠状动脉扩张症（CAE），动脉部分变宽，在多达3-5％的血管造影病例中发现是一种罕见的疾病。有时在CAE受试者中已经报道了主要不良心脏事件(MACE)的复发。本系统综述旨在收集和总结在严重闭塞/重度血栓的CAE患者中除单一抗血小板/双重抗血小板治疗（SAPT/DAPT）外使用抗凝剂是否有效和安全地降低MACE的发生率/复发率的报告。
方法：进行了系统全面的搜索，涵盖了PubMed，Scopus,ISIWebofScience,和谷歌学者数据库。
结果：共发现25项研究，包括20例病例报告，四个案例系列，和一项随机临床试验。20例病例报告中有15例为男性（75%），5人是女性（25%）。在四个案例系列中，在超过50%的患者中，所有患者在DAPT+抗凝剂后都显示出阳性结果；2例仅服用DAPT，13例服用抗凝剂±DAPT，五个人比较了两者。接受DAPT的病例仅出现MACE复发。其他病例在使用抗凝剂±DAPT后，MACE较少，预后较好。这些病例系列包括457例CAE患者的结果显示，超过80%的受试者是男性，在所有针对药物干预的研究中，包括抗血小板和抗凝（华法林）治疗，减少MACE和死亡率。
结论：可以得出结论，抗血小板（SAPT/DAPT）必须与抗凝剂联合应用，以提供更有效的CAE患者预防MACE的保护。然而,需要进一步的高质量随机临床试验来确认结果.
方法：进行了系统全面的搜索，涵盖了PubMed，Scopus,ISIWebofScience,和谷歌学者数据库。
结果：共发现25项研究，包括20例病例报告，四个案例系列，和一项随机临床试验。20例病例报告中有15例为男性（75%），5人是女性（25%）。在四个案例系列中，在超过50%的患者中，所有患者在DAPT+抗凝剂后都显示出阳性结果；2例仅服用DAPT，13例服用抗凝剂±DAPT，五个人比较了两者。接受DAPT的病例仅出现MACE复发。其他病例在使用抗凝剂±DAPT后，MACE较少，预后较好。这些病例系列包括457例CAE患者的结果显示，超过80%的受试者是男性，在所有针对药物干预的研究中，包括抗血小板和抗凝（华法林）治疗，减少MACE和死亡率。
结论：可以得出结论，抗血小板（SAPT/DAPT）必须与抗凝剂联合应用，以提供更有效的CAE患者预防MACE的保护。然而,需要进一步的高质量随机临床试验来确认结果.
