Evidence map›Paper›PMID 33568555›Full record

ArticleOpen heart2021

Coronary artery aneurysms: outcomes following medical, percutaneous interventional and surgical management.

Shameer Khubber, Rajdeep Chana, Chandramohan Meenakshisundaram, Kamal Dhaliwal, Mohomed Gad, Manpreet Kaur, Kinjal Banerjee, Beni Rai Verma, Shashank Shekhar, Muhummad Zia Khan and 12 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Open heart, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 1 pooled it
4.6field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.

  1. Pooled it
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  11. Giant coronary aneurysm and acute myocardial infarction: clinical case report and literature review.Clinical research in cardiology : official journal of the German Cardiac Society · 2024
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  12. Article
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  16. Coronary Arteries Aneurysms: A Case-Based Literature Review.Diagnostics (Basel, Switzerland) · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors at 4 institutions in 2 countries.

Shameer KhubberHeart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.ORCID 0000-0002-6454-8281
Rajdeep ChanaHeart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Chandramohan MeenakshisundaramHeart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Kamal DhaliwalHeart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Mohomed GadHeart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Manpreet KaurHeart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Kinjal BanerjeeDepartment of Internal Medicine, Geisinger Medical Center, Danville, Pennsylvania, USA.
Beni Rai VermaHeart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Shashank ShekharHeart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Muhummad Zia KhanDepartment of Medicine, West Virginia University, Morgantown, West Virginia, USA.
Muhammad Shahzeb KhanMedicine, John H Stroger Hospital of Cook County, Chicago, Illinois, USA.ORCID 0000-0003-1250-6351
Safi KhanDepartment of Medicine, Guthrie Robert Packer Hospital, Sayre, Pennsylvania, USA.
Yasser SammourHeart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Rayji TsutsuiHeart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Rishi PuriHeart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Ankur KalraCardiology, Cleveland Clinic, Cleveland, Ohio, USA.
Faisal G BakaeenHeart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Conrad SimpfendorferHeart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Stephen EllisHeart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Douglas JohnstonHeart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Gosta PetterssonDepartment of Cardiothoracic Surgery, Cleveland Clinic, Cleveland, Ohio, USA.
Samir KapadiaHeart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA kapadis@ccf.org.
Cleveland Clinic · USWest Virginia University · USGeisinger Medical Center · USSUNY Upstate Medical University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCoronary artery aneurysms (CAAs) are increasingly diagnosed on coronary angiography; however, controversies persist regarding their optimal management. In the present study, we analysed the long-term outcomes of patients with CAAs following three different management strategies.

methodsWe performed a retrospective review of patient records with documented CAA diagnosis between 2000 and 2005. Patients were divided into three groups: medical management versus percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG). We analysed the rate of major cardiovascular and cerebrovascular events (MACCEs) over a period of 10 years.

resultsWe identified 458 patients with CAAs (mean age 78±10.5 years, 74.5% men) who received medical therapy (N=230) or underwent PCI (N=52) or CABG (N=176). The incidence of CAAs was 0.7% of the total catheterisation reports. The left anterior descending was the most common coronary artery involved (38%). The median follow-up time was 62 months. The total number of MACCE during follow-up was 155 (33.8%); 91 (39.6%) in the medical management group vs 46 (26.1%) in the CABG group vs 18 (34.6%) in the PCI group (p=0.02). Kaplan-Meier survival analysis showed that CABG was associated with better MACCE-free survival (p log-rank=0.03) than medical management. These results were confirmed on univariate Cox regression, but not multivariate regression (OR 0.773 (0.526 to 1.136); p=0.19). Both Kaplan-Meier survival and regression analyses showed that dual antiplatelet therapy (DAPT) and anticoagulation were not associated with significant improvement in MACCE rates.

conclusionOur analysis showed similar long-term MACCE risks in patients with CAA undergoing medical, percutaneous and surgical management. Further, DAPT and anticoagulation were not associated with significant benefits in terms of MACCE rates. These results should be interpreted with caution considering the small size and potential for selection bias and should be confirmed in large, randomised trials.

Indexed as

Drug-Eluting StentsAgedCoronary AneurysmCoronary AngiographyCoronary Artery BypassCoronary VesselsFemaleFibrinolytic AgentsFollow-Up StudiesHumansMalePercutaneous Coronary InterventionRetrospective StudiesThrombolytic TherapyTreatment OutcomeFibrinolytic Agentscoronary aneurysmcoronary artery diseasecoronary vesselspercutaneous coronary intervention

Identifiers

PMID33568555
PMCPMC7878141
OpenAlexW3128273519

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.