Increased prevalence of coronary ectasia in heterozygous familial hypercholesterolemia

Krishnankutty Sudhir, Thomas A. Ports, Thomas M. Amidon, Jeffrey Goldberger, Vikas Bhushan, John P. Kane, Paul Yock, Mary J. Malloy

Research output: Contribution to journalArticle

81 Citations (Scopus)

Abstract

Background: Although coronary atherosclerosis most commonly produces clinical effects as a result of stenosis, aneurysmal disease also occurs. We have found an increased prevalence of ectasia and aneurysmal disease in familial hypercholesterolemia (FH) suggesting a link between plasma lipoproteins and coronary aneurysms. Methods and Results: In 197 asymptomatic subjects with FH, we examined the prevalence of ectasia and its association with coronary risk factors. An ectatic segment was defined as one with a luminal diameter >1.5 times that of the adjacent normal segment, excluding poststenotic dilation. Among subjects with FH, 15% had ectasia compared with 2.5% of an age- and sex-matched control group of 198 subjects without FH presenting for coronary angiography (P<.001). These control patients had significantly more severe coronary atherosclerosis than patients with FH. Ectasia was 3 times more common in men than women (P<.025). Neither age nor hypertension was predictive. Although in part reflecting the striking sex differential, ectasia was strongly associated with a lower HDL cholesterol level (P=.003), a higher LDL/HDL ratio (P=.003), and to a lesser extent, a higher LDL cholesterol level (P=.07). No association was found with plasma triglycerides or very low-density lipoprotein cholesterol levels. Among FH patients, ectasia was strongly associated with an overall index of occlusive atherosclerotic disease, based on quantitative angiography (P=.004). Intracoronary ultrasound interrogation of aneurysmal segments revealed circumferential intimal thickening. Conclusions: Coronary ectasia is more prevalent in patients with FH than in other patients with coronary atherosclerosis and shows a strong inverse association with HDL cholesterol levels. This suggests that disordered lipoprotein metabolism in FH may predispose patients to aneurysmal coronary artery disease.

Original languageEnglish (US)
Pages (from-to)1375-1380
Number of pages6
JournalCirculation
Volume91
Issue number5
DOIs
StatePublished - Mar 1 1995
Externally publishedYes

Fingerprint

Pathologic Dilatations
Hyperlipoproteinemia Type II
Coronary Artery Disease
HDL Cholesterol
Lipoproteins
Tunica Intima
Coronary Aneurysm
VLDL Cholesterol
Hypercholesterolemia
Coronary Angiography
LDL Cholesterol
Dilatation
Angiography
Pathologic Constriction
Triglycerides
Research Design
Hypertension
Control Groups

Keywords

  • aneurysm
  • angiography
  • hypercholesterolemia
  • lipoproteins
  • risk factors

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Sudhir, K., Ports, T. A., Amidon, T. M., Goldberger, J., Bhushan, V., Kane, J. P., ... Malloy, M. J. (1995). Increased prevalence of coronary ectasia in heterozygous familial hypercholesterolemia. Circulation, 91(5), 1375-1380. https://doi.org/10.1161/01.CIR.91.5.1375

Increased prevalence of coronary ectasia in heterozygous familial hypercholesterolemia. / Sudhir, Krishnankutty; Ports, Thomas A.; Amidon, Thomas M.; Goldberger, Jeffrey; Bhushan, Vikas; Kane, John P.; Yock, Paul; Malloy, Mary J.

In: Circulation, Vol. 91, No. 5, 01.03.1995, p. 1375-1380.

Research output: Contribution to journalArticle

Sudhir, K, Ports, TA, Amidon, TM, Goldberger, J, Bhushan, V, Kane, JP, Yock, P & Malloy, MJ 1995, 'Increased prevalence of coronary ectasia in heterozygous familial hypercholesterolemia', Circulation, vol. 91, no. 5, pp. 1375-1380. https://doi.org/10.1161/01.CIR.91.5.1375
Sudhir, Krishnankutty ; Ports, Thomas A. ; Amidon, Thomas M. ; Goldberger, Jeffrey ; Bhushan, Vikas ; Kane, John P. ; Yock, Paul ; Malloy, Mary J. / Increased prevalence of coronary ectasia in heterozygous familial hypercholesterolemia. In: Circulation. 1995 ; Vol. 91, No. 5. pp. 1375-1380.
@article{c23cb97d06294c5dafb9d779247d4f17,
title = "Increased prevalence of coronary ectasia in heterozygous familial hypercholesterolemia",
abstract = "Background: Although coronary atherosclerosis most commonly produces clinical effects as a result of stenosis, aneurysmal disease also occurs. We have found an increased prevalence of ectasia and aneurysmal disease in familial hypercholesterolemia (FH) suggesting a link between plasma lipoproteins and coronary aneurysms. Methods and Results: In 197 asymptomatic subjects with FH, we examined the prevalence of ectasia and its association with coronary risk factors. An ectatic segment was defined as one with a luminal diameter >1.5 times that of the adjacent normal segment, excluding poststenotic dilation. Among subjects with FH, 15{\%} had ectasia compared with 2.5{\%} of an age- and sex-matched control group of 198 subjects without FH presenting for coronary angiography (P<.001). These control patients had significantly more severe coronary atherosclerosis than patients with FH. Ectasia was 3 times more common in men than women (P<.025). Neither age nor hypertension was predictive. Although in part reflecting the striking sex differential, ectasia was strongly associated with a lower HDL cholesterol level (P=.003), a higher LDL/HDL ratio (P=.003), and to a lesser extent, a higher LDL cholesterol level (P=.07). No association was found with plasma triglycerides or very low-density lipoprotein cholesterol levels. Among FH patients, ectasia was strongly associated with an overall index of occlusive atherosclerotic disease, based on quantitative angiography (P=.004). Intracoronary ultrasound interrogation of aneurysmal segments revealed circumferential intimal thickening. Conclusions: Coronary ectasia is more prevalent in patients with FH than in other patients with coronary atherosclerosis and shows a strong inverse association with HDL cholesterol levels. This suggests that disordered lipoprotein metabolism in FH may predispose patients to aneurysmal coronary artery disease.",
keywords = "aneurysm, angiography, hypercholesterolemia, lipoproteins, risk factors",
author = "Krishnankutty Sudhir and Ports, {Thomas A.} and Amidon, {Thomas M.} and Jeffrey Goldberger and Vikas Bhushan and Kane, {John P.} and Paul Yock and Malloy, {Mary J.}",
year = "1995",
month = "3",
day = "1",
doi = "10.1161/01.CIR.91.5.1375",
language = "English (US)",
volume = "91",
pages = "1375--1380",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Increased prevalence of coronary ectasia in heterozygous familial hypercholesterolemia

AU - Sudhir, Krishnankutty

AU - Ports, Thomas A.

AU - Amidon, Thomas M.

AU - Goldberger, Jeffrey

AU - Bhushan, Vikas

AU - Kane, John P.

AU - Yock, Paul

AU - Malloy, Mary J.

PY - 1995/3/1

Y1 - 1995/3/1

N2 - Background: Although coronary atherosclerosis most commonly produces clinical effects as a result of stenosis, aneurysmal disease also occurs. We have found an increased prevalence of ectasia and aneurysmal disease in familial hypercholesterolemia (FH) suggesting a link between plasma lipoproteins and coronary aneurysms. Methods and Results: In 197 asymptomatic subjects with FH, we examined the prevalence of ectasia and its association with coronary risk factors. An ectatic segment was defined as one with a luminal diameter >1.5 times that of the adjacent normal segment, excluding poststenotic dilation. Among subjects with FH, 15% had ectasia compared with 2.5% of an age- and sex-matched control group of 198 subjects without FH presenting for coronary angiography (P<.001). These control patients had significantly more severe coronary atherosclerosis than patients with FH. Ectasia was 3 times more common in men than women (P<.025). Neither age nor hypertension was predictive. Although in part reflecting the striking sex differential, ectasia was strongly associated with a lower HDL cholesterol level (P=.003), a higher LDL/HDL ratio (P=.003), and to a lesser extent, a higher LDL cholesterol level (P=.07). No association was found with plasma triglycerides or very low-density lipoprotein cholesterol levels. Among FH patients, ectasia was strongly associated with an overall index of occlusive atherosclerotic disease, based on quantitative angiography (P=.004). Intracoronary ultrasound interrogation of aneurysmal segments revealed circumferential intimal thickening. Conclusions: Coronary ectasia is more prevalent in patients with FH than in other patients with coronary atherosclerosis and shows a strong inverse association with HDL cholesterol levels. This suggests that disordered lipoprotein metabolism in FH may predispose patients to aneurysmal coronary artery disease.

AB - Background: Although coronary atherosclerosis most commonly produces clinical effects as a result of stenosis, aneurysmal disease also occurs. We have found an increased prevalence of ectasia and aneurysmal disease in familial hypercholesterolemia (FH) suggesting a link between plasma lipoproteins and coronary aneurysms. Methods and Results: In 197 asymptomatic subjects with FH, we examined the prevalence of ectasia and its association with coronary risk factors. An ectatic segment was defined as one with a luminal diameter >1.5 times that of the adjacent normal segment, excluding poststenotic dilation. Among subjects with FH, 15% had ectasia compared with 2.5% of an age- and sex-matched control group of 198 subjects without FH presenting for coronary angiography (P<.001). These control patients had significantly more severe coronary atherosclerosis than patients with FH. Ectasia was 3 times more common in men than women (P<.025). Neither age nor hypertension was predictive. Although in part reflecting the striking sex differential, ectasia was strongly associated with a lower HDL cholesterol level (P=.003), a higher LDL/HDL ratio (P=.003), and to a lesser extent, a higher LDL cholesterol level (P=.07). No association was found with plasma triglycerides or very low-density lipoprotein cholesterol levels. Among FH patients, ectasia was strongly associated with an overall index of occlusive atherosclerotic disease, based on quantitative angiography (P=.004). Intracoronary ultrasound interrogation of aneurysmal segments revealed circumferential intimal thickening. Conclusions: Coronary ectasia is more prevalent in patients with FH than in other patients with coronary atherosclerosis and shows a strong inverse association with HDL cholesterol levels. This suggests that disordered lipoprotein metabolism in FH may predispose patients to aneurysmal coronary artery disease.

KW - aneurysm

KW - angiography

KW - hypercholesterolemia

KW - lipoproteins

KW - risk factors

UR - http://www.scopus.com/inward/record.url?scp=0028966654&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028966654&partnerID=8YFLogxK

U2 - 10.1161/01.CIR.91.5.1375

DO - 10.1161/01.CIR.91.5.1375

M3 - Article

C2 - 7867176

AN - SCOPUS:0028966654

VL - 91

SP - 1375

EP - 1380

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 5

ER -