Abstract 11611: Prognostic Value of Coronary Vessel Dominance in Relation to Significant Coronary Artery Disease Determined Using Non-Invasive Computed Tomography Coronary Angiography
Objectives: Limited information is available regarding the relationship between prognosis and coronary vessel dominance determined on computed tomography coronary angiography (CTA). Therefore, the purpose of this study was to determine the prognostic value of coronary vessel dominance in relation to significant CAD in patients referred for CTA.
Methods: A total of 1425 patients (869 men, 57±12 years) referred for CTA were analyzed. Cumulative incidences of the composite endpoint (non-fatal myocardial infarction and all-cause mortality) were estimated with Kaplan Meier analysis deviding the population according to the presence of significant CAD and coronary vessel dominance. Moreover, Cox regression analysis was used to assess the prognostic value of coronary vessel dominance in combination with stenosis location.
Results: The prevalence of a right dominant, left dominant and balanced coronary artery system was 88%, 9.2% and 2.7%, respectively. The presence of a left dominant coronary artery system was an independent determinant of the composite endpoint (HR 3.64; 95%CI 1.93-6.86, p<0.001). In patients with significant CAD on CTA, those with a left dominant coronary artery system showed a significantly worse outcome compared to patients with a right dominant coronary artery system at 3-year of follow-up (Figure 1).
Conclusions: The presence of a left dominant coronary artery system was identified as an independent predictor of non-fatal myocardial infarction and all-cause mortality, especially in patients with significant CAD on CTA. Therefore, the assessment of coronary vessel dominance on CTA may further enhance risk stratification beyond the assessment of significant CAD on CTA.
- © 2011 by American Heart Association, Inc.