Isolated Coronary Arteritis in Adults: a Single-Center Experience from China

Abstract

Isolated coronary arteritis (ICA) is an extremely rare and life-threatening vasculitis with only a limited number of reports in the literature. We retrospectively reviewed the clinical data of 10 ICA patients in our center from 2012 to 2022 and compared them with patients with Takayasu arteritis who presented with coronary arteritis initially (TAK-CA patients). We found that ICA predominantly affected women and most commonly involved the ostium and the proximal segment of the coronary arteries, causing mainly stenotic lesions. The C-reactive protein and erythrocyte sedimentation rate were grossly normal and significantly lower than those of TAK-CA patients (p = 0.027, p = 0.009, respectively). Intravascular ultrasound imaging showed superiority in differentiating coronary vasculitis from atherosclerosis. Restenosis of the coronary arteries occurred rapidly if not treated promptly and appropriately. Systemic glucocorticoid combined with immunosuppressive agents, especially cyclophosphamide, was a promising strategy for treating ICA.

Keywords: Coronary arteritis; Coronary artery disease; Coronary vasculitis; Single-organ vasculitis.