Association of indexed aortic dimensions with the presence and extent of coronary artery ectasia in patients with acute coronary syndrome.

Background: Conflicting findings have been reported on the potential association between CAE and aortic dilatation. This study aimed to investigate the relationship between CAE extent and aortic dimensions in patients with acute coronary syndrome (ACS). Methods: This retrospective cohort study included 448 adult patients who underwent coronary angiography for ACS between 2004 and 2015. The cohort was divided into 224 patients with CAE and 224 control patients without CAE, matched for age, sex, and hypertension. Aortic dimensions at the annulus, sinus of Valsalva (SOV), sinotubular junction (STJ), and ascending aorta were measured using transthoracic echocardiography and indexed to body surface area (BSA). The extent of CAE was classified using the Markis and Markis-Harirkrishnan systems. Statistical analysis included ANOVA to assess differences in aortic dimensions and their correlation with CAE extent. Results: Patients with CAE had significantly larger non-indexed aortic dimensions compared to those without CAE (e.g., ascending aorta diameter: 35.2 ± 4.0 mm vs. 33.6 ± 3.7 mm, p < 0.0001). However, when indexed to BSA, these differences were not significant. No significant correlation was found between CAE extent and aortic dimensions (e.g., indexed ascending aorta: F = 1.161, p = 0.325). The incidence of bicuspid aortic valve was similar between both groups (0.9 % vs. 0.4 %, p = 0.554). Conclusion: In patients with ACS, there were no significant differences in indexed aortic diameters in those with and without CAE. Additionally, no correlation was found between CAE extent and aortic dimensions and the incidence of bicuspid aortic valve was comparable in both groups.