Smoking is a Strong Independent Predictor of Acute Coronary Syndrome Among Patients with Coronary Artery Ectasia

Introduction: The independent relationship between smoking and Acute Coronary syndrome (ACS), among other risk factors, was investigated in patients with ectasic coronary arteries. Methods: Between June 2015 and August 2018, 10.320 coronary angiography processes performed in our clinic were analyzed retrospectively. Coronary artery ectasia (CAE) was defined as the enlargement of a coronary artery to 1.5 times or more than that of the local or adjacent normal coronary artery segment. Patients were divided into two groups with (group 1) and without ACS (group 2). The two groups were compared in terms of demographic characteristics, laboratory findings and major risk factors such as hypertension, diabetes mellitus (DM) and smoking. Multivariate logistic regression analysis was used to evaluate independent predictors of ACS in patients with CAE. Results: There were 189 (1.8%) patients with CAE and 143 (76%) of them were male. Of the patients, 107 (57%) were smoking, 106 (56%) had hypertension and 43 (22%) had DM. One hundred two (54%) of the patients presented with ACS. There was no significant difference between the groups in terms of hypertension, DM and basic laboratory characteristics. Smoking rate was significantly higher in the ACS group (66% and 34%, p=0.001). In multivariate logistic regression analysis, when hypertension, DM, age, gender and smoking were evaluated together, smoking was strongly predictive of ACS in patients with ectasic coronary artery [odds ratio: 2.34, (95% confidence interval), 1.093-4.983, p=0.028]. Conclusion: When the factors that play an important role in the etiology of ACS are evaluated together in patients with CAE, smoking predicts ACS strongly and independently.