Severe coronary tortuosity and the relationship to significant coronary artery disease

Severe coronary artery tortuosity on coronary angiogram has not been previously evaluated to determine whether it is associated with coronary artery disease or risk factors for coronary artery disease. A retrospective analysis of all patients who underwent coronary angiography at West Virginia University Hospital during an eight month period was performed. All patients with severe coronary tortuosity (SCT), defined as two consecutive 180 degrees turns by visual estimation in a major epicardial artery, were identified and their medical records reviewed for the presence of coronary artery disease risk factors and presence of significant coronary artery disease. A randomly chosen group of patients who underwent coronary angiography during the same time who did not have SCT was used for a control group. Multivariable analysis using logistic regression was performed to determine predictors of SCT. Severe coronary tortuosity was found in 12.45% of our 1221 patients. Female gender was found to be significantly higher in the tortuosity group of patients compared to the control group (p = 0.039). The presence of severe tortuosity was associated with a statistically significant lower incidence of significant coronary artery disease (p = 0.003). Hypertension, hyperlipidemia, smoking, family history of coronary artery disease, diabetes mellitus, and age > or =65 years were not predictors of SCT. Our study did not find that coronary artery disease risk factors were predictors of coronary tortuosity. Future investigations may provide further insight into the significance or cause of coronary artery tortuosity.