Background: Coronary artery ectasia (CAE) is an uncommon condition characterized by abnormal dilation of the coronary arteries. Identifying predictors of isolated CAE within specific populations is essential for timely detection and management. This study aimed to assess the risk factors and clinical criteria that serve as predictors of isolated CAE in the Egyptian population referred to our catheterization laboratory for coronary angiography.
 
Methods: This retrospective study was carried out in the catheterization laboratory at Misr University for Science and Technology (MUST) Hospital. Between November 2018 and October 2022, out of 2100 patients undergoing coronary angiography, 40 patients diagnosed with isolated CAE and 252 patients with normal coronary angiography were included as the study and control groups, respectively. The results of the coronary angiography were evaluated by 2 experienced interventional cardiologists. Logistic regression analysis was employed to identify the predictors of CAE.
 
Results: The incidence of isolated CAE was 1.9% among patients undergoing coronary angiography. The majority of patients with isolated CAE were male (80%), with a mean age of 54.62 years. Significant predictors of CAE included smoking status, with 60% of the CAE group being smokers compared to 24.6% in the control group (P < 0.001). The multivariate logistic regression analysis identified smoking as the sole independent determinant of CAE, demonstrated by an odds ratio of 7.769, a 95% confidence interval ranging from 3.311 to 18.229, and a statistically significant P-value (< 0.001). Other factors, such as diabetes mellitus, hypertension, and dyslipidemia, did not exhibit a significant independent association with CAE.
 
Conclusions: In the Egyptian population, smoking is a significant and independent predictor of isolated CAE. (Iranian Heart Journal 2025; 26(3): 41-50)