ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Atherosclerosis and Vascular Medicine
Adult Isolated Coronary Artery Ectasia: Clinical Features and Long-Term Outcomes
Yihan Weng 1,2
Jiquan Xiao 3,2
Xiang He 4,2
Yusi Huang 3,2
Wenzhi Hu 3,2
Renshang Xu 5,2
Huimin Yu 2,4,5,6
1. Shantou University Medical College, Shantou, China
2. Guangdong Provincial People's Hospital Guangdong Institute of Cardiovascular Diseases, Guangzhou, China
3. South China University of Technology, Guangzhou, China
4. Guangdong Cardiovascular Institute, Guangzhou, China
5. Southern Medical University, Guangzhou, China
6. Guangdong Provincial People's Hospital Nanhai Hospital, Foshan, China
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Abstract
Background: Adult isolated coronary artery ectasia (ICAE) is a rare disease characterized by dilation of coronary arteries in the absence of significant stenosis. Its long-term prognosis and optimal management remain unclear. This study aimed to investigate the clinical and long-term outcomes of adult ICAE compared to controls with normal coronary arteries. Methods: This retrospective analysis utilized prospectively maintained coronary angiography databases at Guangdong Provincial People's Hospital (2012 - 2022). ICAE was defined as ≥1.5 times dilation with <20% stenosis. Adult patients meeting these criteria, after excluding cases with significant stenosis or secondary causes, were matched 1:1 by age and sex to controls with normal coronary arteries. Clinical, laboratory, ECG, echocardiographic, and angiographic data were collected. The primary outcome was all-cause mortality, and the secondary outcome was major adverse cardiovascular events (MACE). Results: The study included 171 adult ICAE patients and 171 matched controls. Compared to controls, ICAE patients exhibited a higher prevalence of hypertension, elevated cardiac biomarkers, and more frequent ECG abnormalities. Angiography showed a predilection for the LAD (70.8%) and frequent multivessel involvement; slow flow was noted in 26.9%. After a median 6.2-year follow-up, ICAE patients had a significantly increased risk of MACE (HR 2.17, 95% CI 1.23–3.82, p=0.006), while all-cause mortality was similar (HR 1.07, 95% CI 0.43–2.63, p=0.886). Conclusions: Adult ICAE exhibits distinct clinical and angiographic features, consistent with a chronic ischemia–like phenotype and possible association with elevated MACE risk.
Summary
Keywords
Adult, Angiography, Ischemia, Isolated coronary artery ectasia, prognosis
Received
29 November 2025
Accepted
06 February 2026
Copyright
© 2026 Weng, Xiao, He, Huang, Hu, Xu and Yu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Huimin Yu
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