Abstract 12106: Anomalous Coronary Arteries have More Acute Take-off Angles and Smaller Ostial Areas than Normal Controls: A 64-Detector Coronary Angiography Analysis
Background: Coronary artery anomalies (CAA) have been implicated in sudden cardiac death attributed to the presence of acute take-off angles and narrow ostial areas. We hypothesized that left and right CAAs would have more acute take-off angles and narrower ostial areas than normal controls using 64-detector coronary angiography (64-CT).
Methods: A retrospective database review of 5,438 patients undergoing 64-CT (GE Light Speed VCTTM) between April 2005 and June 2009 was performed. CAA were identified and categorized. Take-off angles and ostial areas were measured in right and left CAA and compared with controls using one way ANOVA and Tukey's Studentized Range test.
Results: In a series of 5,438 consecutive patients, 177 CAA were identified in 169 patients, (3.3% prevalence, 99 male, ages 6-89). In all right CAA, except for origin of the circumflex from the right coronary artery (RCA), the mean take-off angles were more acute and the ostial areas were smaller than the RCA in controls. In a subgroup analysis, anomalous origin of the RCA from the left sinus had significantly more acute take-off angles than all other right CAA and smaller ostial areas than high take-off RCAs. The mean take-off angles and ostial areas of all left CAAs were more acute and smaller than the left coronary artery (LCA) in controls. Anomalous origin of the LCA from the right sinus had significantly more acute take-off angles than all other LCA anomalies and smaller ostial areas than high take-off LCAs.
Conclusions: In this large cohort of patients, right and left CAA had significantly more acute take-off angles and smaller ostial areas than the right and left coronary arteries in normal controls. Anomalous coronary arteries originating from the opposite sinus demonstrated significantly more acute take-off angles than all other CAA. Further work toward establishing a risk stratification schema for CAA using quantified take-off angles and ostial areas is warranted.
- © 2010 by American Heart Association, Inc.