Coronary artery tortuosity: comparison with retinal arteries and carotid intima-media thickness

We conducted a prospective study to investigate the possible relationship between the tortuosity of coronary arteries (TCA) and carotid intima-media thickness (CIMT), and also compare TCA to retinal artery tortuosity.

One hundred and five participants with nonsignificant coronary plaque or normal coronary angiogram were included. To determine subclinical atherosclerosis, maximum CIMT was measured. Retinal tortuosity was evaluated ophthalmically.

Among all demographic variables and risk factors, only female gender and height were significantly associated with TCA (p = 0.001, p = 0.01, respectively). Retinal artery tortuosity and retinal artery atherosclerosis were more common inpatients with TCA compared to patients without TCA (p < 0.001, R = 0.6; p = 0.002, R = 0.4, respectively). CIMT was greater in participants with TCA than patients without TCA (p = 0.001), and also the presence of carotid artery plaque was more common in patients with TCA (p < 0.001). There was a significant correlation between the presence of subclinical atherosclerosis and TCA (p = 0.005, R = 0.3). Likewise, a significant correlation was found between subclinical atherosclerosis and retinal artery tortuosity (p = 0.02, R = 0.3). Multivariate analysis identified female gender (p < 0.008), retinal arterytortuosity (p < 0.001), and CIMT (p = 0.02) as independent predictors of TCA.

These results indicate that, whatever the mechanism is: 1) TCA is associated with female gender and short stature; 2) TCA is associated with subclinical atherosclerosis even in patients with entirely normal appearing coronary arteries on coronary angiography; 3) Retinal artery tortuosity is correlated with TCA and can be a surrogate for systemic arterial tortuosity.