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

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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.

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Data Availability

The data are available from the corresponding author on reasonable request.

Abbreviations

ICA:

Isolated coronary arteritis

CA:

Coronary arteritis

TAK:

Takayasu arteritis

PET/CT:

Positron emission tomography/computed tomography

CAG:

Invasive coronary angiography

CTA:

Computed tomography angiography

CAD:

Coronary atherosclerotic heart disease

WBC:

White blood cell

ESR:

Erythrocyte sedimentation rate

CRP:

C-reactive protein

LM:

Left main

LAD:

Left anterior descending

LCX:

Left coronary circumflex artery

CABG:

Coronary artery bypass graft

IVUS:

Intravascular ultrasound

VH:

Virtual histology

CYC:

Cyclophosphamide

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Acknowledgements

The authors thank the patients for participating in this study.

Funding

This study was supported by the Chinese Academy of Medical Sciences (CAMS) Innovation Fund for Medical Sciences (CIFMS) (2021-I2M-1–005).

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Authors and Affiliations

  1. Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuaifuyuan, Beijing, 100730, China

    Lingyu Liu, Jing Li, Yunjiao Yang & Xinping Tian

  2. National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, Beijing, China

    Xinping Tian

  3. State Key Laboratory of Complex Severe and Rare Diseases, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Peking Union Medical College Hospital (PUMCH), Beijing, 100730, China

    Xinping Tian

  4. Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China

    Tianpeng Gan

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  1. Lingyu Liu
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Correspondence to Xinping Tian.

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Human Subjects Statement

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

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The authors declare no competing interests.

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Associate Editor Angela Taylor oversaw the review of this article.

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Liu, L., Li, J., Gan, T. et al. Isolated Coronary Arteritis in Adults: a Single-Center Experience from China. J. of Cardiovasc. Trans. Res. 16, 1184–1193 (2023). https://doi.org/10.1007/s12265-023-10388-4

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