CAEA is independently associated with unfavorably altered fibrin clot properties, reflected by denser clot structure and reduced susceptibility to fibrinolysis, and oxidative stress may contribute to this modification.
Patients with coronary artery ectasias and aneurysms (CAEA) had a denser fibrin clot structure than matched controls, reflected by lower fibrin clot permeability (Ks).
Patients with CAEA had reduced susceptibility of fibrin clots to fibrinolysis, shown by longer clot lysis time (CLT).
Patients with CAEA had higher levels of the oxidative stress marker 3-nitrotyrosine than controls.
Within CAEA patients, oxidative stress correlated with unfavorable fibrin clot properties.
Greater CAEA size, measured as peak-to-reference diameter ratio, was associated with worse fibrin clot phenotype and greater oxidative stress.
The CAEA cohort was predominantly male and older, and half had concomitant coronary artery disease.
CAEA is independently associated with unfavorably altered fibrin clot properties.
This study looked at people who have enlarged or bulging sections of their coronary arteries (ectasias and aneurysms), which occur in up to 5% of people having coronary angiography. Earlier research linked these conditions to a higher risk of heart attack, but it was unclear why. The researchers compared blood clot properties in 60 patients with these artery changes and 60 closely matched people without them, at three medical centers. The clots from patients with coronary aneurysms or ectasias were denser (14% less permeable) and took 25% longer to break down than clots from controls. These patients also had 21% higher levels of 3-nitrotyrosine, a marker of oxidative stress. Higher oxidative stress went along with denser clots that dissolved more slowly, and the larger the artery enlargement, the denser the clots and the higher the oxidative stress. This research suggests that the tendency toward heart attack in people with coronary aneurysms may be partly due to blood clots that are harder to break down, possibly influenced by oxidative stress. The study shows association, not proof of cause, and it was fairly small, so further work would be needed to confirm these results and to see whether they could guide treatment.
Chmiel J, Kopytek M, Dąbrowski M, Iwańczyk S, Musiał K, Woźniak P, et al.. (2026). Fibrin Clot Properties in Aneurysmal Coronary Artery Disease: CARE-ANEURYSM Study.. International journal of molecular sciences. https://doi.org/10.3390/ijms27209059