Chronic exposure to high altitude and the presence of coronary ectasia in patients with ST elevation myocardial infarction

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DOI:

https://doi.org/10.47487/apcyccv.v4i4.329

Palabras clave:

Coronary artery disease, Ectasia, Altitude, Myocardial Infarction

Resumen

Objective. To evaluate the association between chronic exposure to high altitude and the presence of coronary ectasia (CE) in patients with ST-segment elevation myocardial infarction (STEMI) treated in a highly specialized cardiovascular reference hospital in Peru. Materials and methods. Retrospective matched case-control study. The cases were patients with CE and controls without CE. The relationship between CE and chronic exposure to high altitude was evaluated considering intervening variables such as arterial hypertension, diabetes mellitus, dyslipidemia, smoking, and hematocrit values. Patients with chronic inflammatory pathologies, chronic obstructive pulmonary disease, and previous revascularization were excluded. Multivariate logistic regression was applied to obtain the OR value and their respective confidence intervals. Results. Eighteen cases and 18 controls were studied, most of them were men with an average age of 65 years. Thirty-six percent of the population came from high altitude; in this group 76.9% had coronary ectasia of the infarct-related artery. The mean hematocrit value was slightly higher in the high-altitude native (46 ± 7% versus 42 ± 5%, p=0.094). Multivariate conditional logistic regression did not find a significant relationship between exposure to high altitude and the risk of presenting CE (OR:6.03, IC95%: 0.30-118, p=0.236). Conclusions. In patients with STEMI, we found no association between chronic exposure to high altitude and coronary ectasia.

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Referencias

Wang X, Montero-Cabezas JM, Mandurino-Mirizzi A, Hirasawa K, Ajmone Marsan N, Knuuti J, et al. Prevalence and Long-term Outcomes of Patients with Coronary Artery Ectasia Presenting with Acute Myocardial Infarction. Am J Cardiol. 2021;156:9-15. doi:10.1016/j.amjcard.2021.06.037.

Doi T, Kataoka Y, Noguchi T, Shibata T, Nakashima T, Kawakami S, et al. Coronary artery ectasia predicts future cardiac events in patients with acute myocardial infarction. Arterioscler Thromb Vasc Biol. 2017;37(12):2350-5. doi: 10.1161/ATVBAHA.117.309683.

Sheng Q, Zhao H, Wu S, Liu R. Underlying factors relating to acute myocardial infarction for coronary artery ectasia patients. Medicine (Baltimore).2020;99(36):e21983. doi: 10.1097/MD.0000000000021983.

Valente S, Lazzeri C, Giglioli C , Sani F, Romano SM, Margheri M, et al. Clinical expression of coronary artery ectasia. J

Cardiovasc Med (Hagerstown). 2007;8(10):815-20. doi: 10.2459/jcm.0b013e3280115667.

Manginas A, Cokkinos D V. Coronary artery ectasias: imaging, functional assessment and clinical implications. Eur Heart J. 2006;27(9):1026-31. doi: 10.1093/eurheartj/ehi725.

Tymko MM, Tremblay JC, Bailey DM, Green DJ, Ainslie PN, Petersen O, et al.The impact of hypoxemia on vascular function in lowlanders and high altitude indigenous populations. J Physiol. 2019;597(24):5759-5776. doi: 10.1113/JP277191.

Ozturk S, Yetkin E, Waltenberger J. Molecular and cellular insights into the pathogenesis of coronary artery ectasia. Cardiovasc Pathol. 2018;35:37-47. doi: 10.1016/j.carpath.2018.04.005.

Giannoglou G, Antoniadis A, Chatzizisis Y, Damvopoulou E, Parcharidis G, Louridas G. Prevalence of ectasia in human coronary arteries in patients in northern Greece referred for coronary angiography. Am J Cardiol. 2006;98(3):314-8. doi: 10.1016/j.amjcard.2006.02.034.

Gürlek A, Esenboğa K, Özcan ÖU, Çiçek ÖF, Ayral PA, Kavas GÖ, et al. Serum nitric oxide levels in patients with coronary artery ectasia. Anatol J Cardiol. 2016;16(12):947-52. doi: 10.14744/AnatolJCardiol.2016.6556.

Yalcin AA, Akturk IF, Celik O, Erturk M, Hancer VS, Yalcin B, et al. Coronary Artery Ectasia Is Associated with the c.894G>T (Glu298Asp) Polymorphism of the Endothelial Nitric Oxide Synthase Gene. Tohoku J Exp Med. 2014;232(2):137-44. doi: 10.1620/tjem.232.137.

Qin Y, Tang C, Ma C, Yan G. Risk factors for coronary artery ectasia and the relationship between hyperlipidemia and coronary artery ectasia. Coron Artery Dis. 2019;30(3):211-5. doi: 10.1097/MCA.0000000000000709.

Dastgir N, Masood A, Muqeet A, Khan Niazi GZ. Frequency of risk factors in patients of acute coronary syndrome due to coronary ectasia. Asian Cardiovasc Thorac Ann. 2020;28(6):312-5. doi: 10.1177/0218492320937155.

Bigham AW. Genetics Of Human Origin and Evolution: High-Altitude Adaptations. Curr Opin Genet Dev. 2016;41:8-13. doi: 10.1016/j.gde.2016.06.018.

Mallet RT, Burtscher J, Richalet J-P, Millet GP, Burtscher M. Impact of High Altitude on Cardiovascular Health: Current Perspectives. Vasc Health Risk Manag. 2021;17:317-35. doi: 10.2147/VHRM.S294121.

Gazal S, Espinoza JR, Austerlitz F, Marchant D, Macarlupu JL, Rodríguez J. et al. The Genetic Architecture of Chronic Mountain Sickness in Peru. Front Genet. 2019;10:690. doi: 10.3389/fgene.2019.00690.

Leon-Velarde F, Arregui A, Vargas M, Huicho L, Acosta R. Chronic mountain sickness and chronic lower respiratory tract disorders. Chest.1994;106(1):151-5. doi: 10.1378/chest.106.1.151.

Aryal N, Weatherall M, Bhatta YKD, Mann S. Blood Pressure and Hypertension in Adults Permanently Living at High Altitude: A Systematic Review and Meta-Analysis. High Alt Med Biol. 2016;17(3):185-193. doi: 10.1089/ham.2015.0118.

Woolcott OO, Castillo OA, Gutierrez C, Elashoff RM, Stefanovski D, Bergman RN. Inverse association between diabetes and altitude: A cross-sectional study in the adult population of the United States. Obesity. 2014;22(9):2080-90. doi: 10.1002/oby.20800.

Hernández-Vásquez A, Vargas-Fernández R, Chacón-Diaz M. Association between Altitude and the Framingham Risk Score: A Cross-Sectional Study in the Peruvian Adult Population. Int J Environ Res Public Heal. 2022;19(7):3838-49. doi: 10.3390/ijerph19073838.

Tremblay JC, Ainslie PN. Global and country-level estimates of human population at high altitude. Proc Natl Acad Sci U S A. 2021;118(18):e2102463118. doi: 10.1073/pnas.2102463118.

Rodríguez D, Rafael-Horna E, Quiroz J, Lévano-Pachas G, Meneses G. Características clínicas y angiográficas de pacientes con ectasia coronaria en un hospital de referencia. Arch Peru Cardiol Cir Cardiovasc. 2022;3(3):139-44. doi: 10.47487/apcyccv.v3i2.229.

Araiza-Garaygordobil D, Gopar-Nieto R, Sierra-Lara Martínez D, Belderrain-Morales N, Sarabia-Chao V, Alfaro-Ponce DL, et al. Dual Antiplatelet Therapy Versus Antiplatelet Monotherapy Plus Oral Anticoagulation in Patients with Acute Coronary Syndrome and Coronary Artery Ectasia: Design and Rationale of OVER-TIME Randomized Clinical Trial. High Blood Press Cardiovasc Prev. 2022;29(5):463-468. doi: 10.1007/s40292-022-00535-4

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13-12-2023

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