Ectatic coronary arteries - increasing trends post covid 19 infection

Abstract Introduction Ectatic coronary arteries in the pre-covid era was a rare entity. After the covid pandemic we are able to appreciate an increasing surge in coronary artery ectasias in adults presenting with acute coronary syndrome. COVID 19 infection is associated with inflammatory response which further leads to endothelial dysfunction which may be persistent, thus leading to coronary ectasia. Purpose The study objective was to investigate the increase in the percentage of ectatic coronary arteries post COVID 19 infections. The patients of age above 18 years were included in the study. Exclusion criteria included age below 18 years and pregnant woman. Materials and Methods Study design: observational study Study centre: Tertiary care centre in South India Study period: 7 years(2017- 2023) The data were collected from 2017-2019 (pre covid) and 2020-2023(post covid), evaluated for coronary ectasia based on the coronary angiographic profile Results Total number of patients studied were 19720. These patients presented with acute coronary syndrome. Of that in pre covid era, 8300 and in post covid era, 11420 patients were studied. Here, 12% of patients in pre covid era and 62% in post covid era were found to have ectatic coronaries. Of these 63% constituted males and 37 %constitutes females .The coronary angiographic profiles were collected from pre covid and post covid period and the number of ectasia in coronaries, predominant type of coronary artery and sex predominance was evaluated, which showed a significant increase in the ectatic coronaries in the post covid period. Conclusion To summarise, the study shows that there is significant increase in ectatic coronary arteries post COVID 19 infections, predominant in male sex than female sex. The most common artery affected by ectasia is left anterior descending artery, followed by right coronary artery, then left circumflex artery and very rarely left main coronary artery. Post covid 19 infection , there is also increase in multivessel ectasia which was not noted during pre-covid era. Covid 19 causes endothelial dysfunction and leads to coronary ectasias which also increases the thrombotic burden and slow flow leading increased ACS events including young patients with no comorbidities constituting around 14%.Ectasia coronaries/Gender differences  PRE/POST COVID COMPARISON OF ECTASIA