Alparslan BİRDANE, Hüseyin Uğur YAZICI, Yüksel AYDAR, Aydın NADİR, Utku ŞENOL, Abdurrahman TASAL, Ömer GÖKTEKİN, Necmi ATA

Relationship between significant coronary artery disease and coronary artery anomalies

In the present study we aimed to investigate the frequency and types of coronary artery anomalies (CAAs) and their correlation with coronary artery disease (CAD). Materials and methods: We assessed retrospectively the coronary angiography records of 8120 adult patients. We defined and classified the CAAs according to the classification system described by Angelini et al. Significant CAD was defined as the presence of angiographic coronary stenosis of >50% of the luminal diameter in at least 1 of the epicardial coronary arteries. Moreover, we compared the frequencies and features of the CAAs among CAD cases. Results: We detected coronary artery anomalies in 3.32% and 64.4% of the patients with significant CAD. The percentage of anomalous coronary artery origin was significantly higher in CAD (–) patients than CAD (+) patients. The incidence of absence of left main coronary artery (LMCA) and the left anterior descending artery originating from the right sinus of Valsalva or the right coronary artery was significantly higher in CAD (-) patients than CAD (+) patients. Conclusion: The development of coronary artery disease might be associated with coronary artery anomalies. In particular, the lack of LMCA seems to restrict the development of CAD.

Anahtar Kelimeler:

Key words: Coronary artery anomaly, coronary artery disease

Relationship between significant coronary artery disease and coronary artery anomalies

Keywords:

Key words: Coronary artery anomaly, coronary artery disease,

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Basso C, Maron BJ, Corrado D, Thiene G. Clinical profile of congenital coronary artery anomalies with origin from the wrong aortic sinus leading to sudden death in young competitive athletes (Review). J Am Coll Cardiol 2000; 35: 1493–501.
Taylor AJ, Rogan KM, Virmani R. Sudden cardiac death associated with isolated congenital coronary artery anomalies. J Am Coll Cardiol 1992; 20: 640–7.
Angelini P, Velasco JA, Flamm S. Coronary anomalies: incidence, pathophysiology, and clinical relevance. Circulation 2002; 105: 2449–54.
Eckart RE, Scoville SL, Campbell CL, Shry EA, Stajduhar KC, Potter RN et al. Sudden death in young adults: a 25-year review of autopsies in military recruits. Ann Intern Med 2004; 141: 829–34.
Cheitlin MD. Coronary anomalies as a cause of sudden death in the athlete. In: Estes NAM, Salem DN, Wang PJ, editors. Sudden Cardiac Death in the Athlete. Armonk, NY: Futura Publishing; 1998. p.379–91.
Pelliccia A. Congenital coronary artery anomalies in young patients: new perspectives for timely identification. J Am Coll Cardiol 2001; 37: 598–600.
Topaz O, DeMarchena R, Perin E, Sommer LS, Mallon SM, Chahine RA. Anomalous coronary arteries: angiographic findings in 80 patients. Int J Cardiol 1992; 34: 129–38.
Engel HJ, Torres C, Page HL Jr. Major variations in anatomical origin of the coronary arteries: angiographic observations in 4,250 patients without associated congenital heart disease. Cathet Cardiovasc Diagn 1975; 1: 157–69.
Kardos A, Babai L, Rudas L, Gaál T, Horváth T, Tálosi L et al. Epidemiology of congenital coronary artery anomalies: a coronary arteriography study on a Central European population. Cathet Cardiovasc Diagn 1997; 42: 270–5.
Tüccar E, Elhan A. Examination of coronary artery anomalies in an adult Turkish population. Turk J Med Sci 2002; 32: 309– 12.
Eid AH, Itani Z, Al-Tannir M, Sayegh S, Samaha A. Primary congenital anomalies of the coronary arteries and relation to atherosclerosis: an angiographic study in Lebanon. J Cardiothorac Surg 2009; 58: 1–7.
Giannoglou GD, Antoniadis AP, Koskinas KC, Chatzizisis YS. Flow and atherosclerosis in coronary bifurcations. Eurointervention 2010; 6: 16–23.
Nakazawa G, Yazdani SK, Finn AV, Vorpahl M, Kolodgie FD, Virmani R. Pathological findings at bifurcation lesions: the impact of flow distribution on atherosclerosis and arterial healing after stent implantation. J Am Coll Cardiol 2010; 55: 1679–87.
Spindola-Franco H, Grose R, Solomon N. Dual left anterior descending coronary artery: angiographic description of important variants and surgical implications. Am Heart J 1983; 105: 445–55.
Durmaz T, Metin MR, Keleş T, Ayhan H, Bozkurt E. A case with type IV dual left anterior descending coronary artery detected by multidetector computed tomography. Turk J Med Sci 2012; 42: 173–6.
Cheitlin MD, De Castro CM, McAllister HA. Sudden death as a complication of anomalous left coronary origin from the anterior sinus of Valsalva: a not-so-minor congenital anomaly. Circulation 1974; 50: 780–7.
Chaitman BR, Lesperance J, Saltiel J, Bourassa MG. Clinical, angiographic, and hemodynamic findings in patients with anomalous origin of the coronary arteries. Circulation 1976; 53: 122–31.
Duygu H, Zoghi M, Nalbantgil S, Kırılmaz B, Türk E, Özerkan F et al. Myocardial bridge: a bridge to atherosclerosis. Anadolu Kardiyol Derg 2007; 7: 12–6.
Li JJ. Is myocardial bridging a bridge connecting to cardiovascular events. Chin Med J 2010; 123: 964–8.
Ge J, Erbel R, Gorge G, Haude M, Meyer J. High wall shear stress proximal to myocardial bridging and atherosclerosis: intracoronary ultrasound and pressure measurements. Br Heart J 1995; 73: 462–5.
Yeboah J, Akosah K, Ailawadi G. Heart failure due to coronary fistulas from the right and left coronary circulation into the right atrium. J Cardiovasc Med 2010; 11: 517–8.
Said SA, Lam J, van der Werf T. Solitary coronary artery fistulas: a congenital anomaly in children and adults. A contemporary review. Congenit Heart Dis 2006; 1: 63–76.