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Review
. 2024 Sep 25;60(10):1574.
doi: 10.3390/medicina60101574.

Management of Coronary Artery Diseases in Systemic Vasculitides: Complications and Strategies

Russka Shumnalieva  1   2   3 , Niya Mileva  4 , Ivan Padjen  5 , Periklis Siliogkas  6 , Lyubomir Chervenkov  7   8 , Konstantina Bakopoulou  9 , Issa El Kaouri  9 , Anna Vasilska  7 , Dimitrina Miteva  3   10 , Dobrin Vassilev  11 , Tsvetelina Velikova  3
Affiliations
Review

Management of Coronary Artery Diseases in Systemic Vasculitides: Complications and Strategies

Russka Shumnalieva et al. Medicina (Kaunas). .

Abstract

Coronary artery disease (CAD) presents a significant risk for patients with systemic vasculitides, a group of disorders characterized by the inflammation of blood vessels. In this review, we focus on the pathophysiological mechanisms, complications, and management strategies for CAD in systemic vasculitides. We highlight how the inflammatory processes inherent in vasculitis contribute to accelerated atherosclerosis and myocardial ischemia. Key strategies in managing CAD in this patient population include using medicine treatments to mitigate vascular inflammation while balancing the risk of promoting cardiovascular events and lifestyle modifications. Understanding the nuanced relationship between systemic vasculitides and CAD is crucial for improving patient outcomes and guiding therapeutic approaches.

Keywords: cardiovascular complications; coronary artery bypass grafting; coronary artery disease; immunosuppressive therapy; percutaneous coronary intervention; personalized medicine; systemic vasculitides.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart of the study inclusion process. CAD—coronary artery disease. Copyright: the authors.
Figure 2
Figure 2
Overlapping cardiac clinical signs of vasculitides and a stepwise clinical approach. Copyright: the authors.
Figure 3
Figure 3
Coronary computed tomographic angiography (CCTA), axial view, and maximum intensity projection (MIP) at the level of the ascending aorta and pulmonary veins. The place of origin of the left main coronary artery is presented (white arrow). A – orientation marker indicating the position of the abdomen; R – orientation marker indicating the right side of the patient. Copyright: the authors.
Figure 4
Figure 4
Coronary computed tomographic angiography (CCTA), oblique view, maximum intensity projection (MIP). The right coronary artery is presented with the normal course and lumen width. The white arrow shows a non-obstructive calcification of the artery wall. Copyright: the authors.
Figure 5
Figure 5
Coronary computed tomographic angiography (CCTA), oblique view, maximum intensity projection (MIP), and cross-sections at different levels of the right coronary artery (RCA). A) Cross-sectional view at the level of ostial RCA with visualization of fibro-lipid plaque and mild stenosis; B) Cross-sectional view at the level of proximal RCA—no evidence of plaque; C) Cross-sectional of the level of mid-RCA—presenting lipid low-attenuation atherosclerotic plaque, causing a significant 50–60% stenosis; D) Cross-sectional view at the level of mid-RCA—noevidence of plaque. Copyright: the authors.
Figure 6
Figure 6
Coronary computed tomographic angiography (CCTA), oblique view, and maximum intensity projection (MIP) present the left anterior descending artery with a total occlusion in the mid-segment of the vessel (white arrow). Copyright: the authors.
Figure 7
Figure 7
A schematic approach in the diagnosis of coronary vasculitides with CAD. TTE: Transthoracic echocardiography; CCA: Conventional coronary angiography +/− therapeutic intervention; CCTA: coronary computed tomographic angiography; MRA: magnetic resonance angiography. Copyright: the authors.
See this image and copyright information in PMC

References

    1. Vats V., Patel K., Sharma D.D., Almansouri N.E., Makkapati N.S.R., Nimal S., Ramteke P., Mohammed Arifuddin B., Jagarlamudi N.S., Narain A., et al. Exploring Cardiovascular Manifestations in Vasculitides: An In-Depth Review. Cureus. 2023;15:e44417. doi: 10.7759/cureus.44417. - DOI - PMC - PubMed
    1. Ali A.M., Yakupoglu H.Y., Fuchs T.A., Larsen T.H., Aukrust P., Gunnarsson R., Saeed S. Cardiac Involvement in Systemic and Local Vasculitides: The Value of Noninvasive Multimodality Imaging. Curr. Probl. Cardiol. 2023;48:101718. doi: 10.1016/j.cpcardiol.2023.101718. - DOI - PubMed
    1. Silveira L.H. Cardiovascular Manifestations of Systemic Vasculitides. Curr. Rheumatol. Rep. 2020;22:72. doi: 10.1007/s11926-020-00952-1. - DOI - PubMed
    1. Weber B., Wallace Z.S., Parks S., Cook C., Huck D.M., Garshick M., Brown J.M., Divakaran S., Hainer J., Dorbala S., et al. Association between Systemic Vasculitis and Coronary Microvascular Dysfunction in the Absence of Obstructive Coronary Artery Disease. Circ. Cardiovasc. Imaging. 2023;16:e014940. doi: 10.1161/CIRCIMAGING.122.014940. - DOI - PMC - PubMed
    1. Jeon C.H., Kim Y.K., Chun E.J., Kim J.A., Yong H.S., Doo K.W., Choi S.I. Coronary artery vasculitis: Assessment with cardiac multi-detector computed tomography. Int. J. Cardiovasc. Imaging. 2015;31((Suppl. 1)):59–67. doi: 10.1007/s10554-015-0652-8. - DOI - PubMed

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