Introduction: Up to date, the management of coronary artery aneurysm
(CAA) is not well defined and depends on local heart team decision. Data reported
in literature are scarce and controversial. We aim to compare the long-term
outcomes of different therapeutic strategies of CAA (medical vs percutaneous
coronary intervention (PCI) vs coronary artery bypass graft(CABG)).
Materials and Methods: A retrospective cohort study was conducted on 100
consecutive patients who underwent coronary angiography at Toulouse University
Hospital, Toulouse France and fulfilled the diagnostic criteria of CAA. Coronary
angiograms were reviewed, and all necessary data were collected. CAA was defined
by a coronary dilation exceedingly at least 50% of reference coronary diameter.
Results: We identified 100 patients with CAA with a mean age of 67.9
12 years. The left anterior descending coronary artery was most affected
(36%). CAA is associated with significant coronary artery disease in 78% of
cases. The incidence of major adverse cardiovascular and cerebrovascular events
(MACCE) was 13% during a median follow-up period of 46.2 24 months. A
53% of patients underwent PCI or CABG. The rate of MACCE was lower in CABG group
(9.1%) compared to PCI (14.3%) and medical (12.8%) groups, but without
reaching statistically significant level. Longitudinal aneurysm diameter was
positively linked to MACCE [OR = 1.109, 95% CI (1.014–1.214), p =
0.024]. No benefits have been attributed to anticoagulant regimen over
antiplatelet therapy. Conclusions: In our retrospective observational
study, there seems to be no significant differences in MACCE-free survival
between all groups (Medical vs PCI vs CABG). Larger longitudinal aneurysm
diameter was identified as a predictor of poor prognosis during follow-up.