Inflammatory Biomarkers in Coronary Artery Ectasia: A Systematic Review and Meta-Analysis
Dimitrios A. Vrachatis, Konstantinos A. Papathanasiou, Dimitrios Kazantzis, Jorge Sanz‐Sánchez, Sotiria G. Giotaki, Konstantinos Raisakis, Andreas Kaoukis, Charalampos Kossyvakis, Gerasimos Deftereos, Bernhard Reimers, Dimitrios Avramides, Gerasimos Siasos, Michael Cleman, Γεώργιος Γιαννόπουλος, Alexandra J. Lansky, Spyridon Deftereos
Abstract
Isolated coronary artery ectasia (CAE) is a relatively rare clinical entity, the pathogenesis of which is poorly understood. More and more evidence is accumulating to suggest a critical inflammatory component. We aimed to elucidate any association between neutrophil to lymphocyte ratio and coronary artery ectasia. A systematic MEDLINE database, ClinicalTrials.gov, medRxiv, Scopus and Cochrane Library search was conducted: 50 studies were deemed relevant, reporting on difference in NLR levels between CAE patients and controls (primary endpoint) and/or on high-sensitive CRP, IL-6, TNF-a and RDW levels (secondary endpoint), and were included in our final analysis. (PROSPERO registration number: CRD42021224195). All inflammatory biomarkers under investigation were found higher in coronary artery ectasia patients as compared to healthy controls (NLR; SMD = 0.73; 95% CI: 0.27-1.20, hs-CRP; SMD = 0.96; 95% CI: 0.64-1.28, IL-6; SMD = 2.68; 95% CI: 0.95-4.41, TNF-a; SMD = 0.50; 95% CI: 0.24-0.75, RDW; SMD = 0.56; 95% CI: 0.26-0.87). The main limitations inherent in this analysis are small case-control studies of moderate quality and high statistical heterogeneity. Our findings underscore that inflammatory dysregulation is implicated in coronary artery ectasia and merits further investigation.