Search

Background Coronary artery ectasia (CAE) is a relatively frequent finding in patient with ST-elevation myocardial infarction (STEMI) who undergo emergent coronary angiography. However, the long-term outcome of STEMI patients with CAE as compared to Non-CAE has been poorly investigated. Purpose To compare the baseline features and outcome of patients with and without CAE in the clinical setting of STEMI. Methods All patients with STEMI who underwent emergent coronary angiography from January 2012 to December 2017 at our Institution were retrospectively enrolled. Baseline demographic, clinical, instrumental, angiographic and percutaneous coronary intervention (PCI) findings were collected for patients with and without CAE. The study outcome measures were recurrent myocardial infarction (MI) and all-cause death. The propensity score weighting (PSW) technique was used to take into account for potential selection bias in treatment assignment between CAE and Non-CAE groups. Results The study included 534 patients with STEMI (mean age 62.9±12.0 years), 154 were CAE and 380 Non-CAE. The two groups were significantly different in terms of sex (90.9% in CAE vs 72,6% in Non-CAE, p The survival free from recurrent MI was lower, although not statistically significant, in CAE vs. Non-CAE patients (3.1/100 person/years vs. 4.8/100 person/years; Log-Rank = 0.068). After PSW, an optimal balance was obtained as demonstrated by a standardized mean difference Conclusions Patient with STEMI and angiographic evidence of CAE have a different clinical profile compared to Non-CAE. In this analysis focused on STEMI patients, CAE was associated with a higher risk of recurrent MI at long-term follow-up. Funding Acknowledgement Type of funding source: None

The authors propose a new research hypothesis about cancer pathology, starting from the hypothesis of considering cancer as a process of adaptation to changed conditions, which can be internal or external to the organism, with the aim of reaching the survival of the species. The authors, in the present work, put forward an hypothesis which is based on the observation of natural phenomenon, referred to the previously described mutations, some as natural evolutionary phenomena which are genetically transmitted as a result of environmental adaptation (for example the color of the skin), some others, with the same modalities, as pathological phenomena (for example thalassemia), some others as more flexible environmental responses (for example human height in relation with the improved food conditions), some others as immediate responses of the organism in order to defend its own biological integrity and individuality (for example violent anaphylactic reactions which happen as consequences of extraneous proteins