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.