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Predictors of coronary tortuosity in patients with chronic coronary syndrome
Ferhat Siyamend Yurdam1, Mehmet Kış2, Yusuf Demir3
1Bakırçay University Çiğli Training and Research Hospital.
Insights
Coronary artery tortuosity, a common finding in chronic coronary syndrome (CCS), can cause myocardial ischemia. Advanced age and hypertension are independent predictors of this condition in CCS patients.
Area of Science:
- Cardiology
- Vascular Medicine
- Diagnostic Imaging
Background:
- Coronary artery tortuosity is a frequent finding during coronary angiography.
- It can lead to myocardial ischemia, even without significant coronary artery stenosis.
- Understanding its predictors is crucial for patient management.
Purpose of the Study:
- To compare demographic, clinical, and echocardiographic features of patients with chronic coronary syndrome (CCS) with and without coronary artery tortuosity.
- To identify predictors associated with coronary artery tortuosity in CCS patients.
Main Methods:
- 361 patients with CCS undergoing elective coronary angiography were included.
- Patients were divided into two groups: with coronary tortuosity (Group 1) and without (Group 2).
- Univariable and multivariable logistic regression analyses were performed to identify predictors.
Main Results:
- Multivariable analysis identified advanced age (OR: 1.059) and hypertension (OR: 0.484) as independent predictors of coronary artery tortuosity.
- Univariable analysis showed associations with female sex, PR interval, QTc interval, ST/T segment changes, LVDD, and LVH.
- The mean age of patients was 56.7±11.5 years, with 44% females.
Conclusions:
- Coronary artery tortuosity is an angiographic finding linked to adaptive cardiac mechanisms and can cause myocardial ischemia.
- Predictors include advanced age, female gender, prolonged PR and QTc intervals, ST/T changes, LVH, and LVDD.
- Evaluating these factors may help anticipate tortuosity in CCS patients, aiding in percutaneous coronary intervention (PCI) precautions.
Abstract:
Aim Coronary artery tortuosity is a common coronary angiographic finding. This tortuosity can cause myocardial ischemia even in the absence of significant coronary artery stenosis. Our aim was to compare the demographic, clinical and echocardiographic features of patients with chronic coronary syndrome (CCS) and with and without coronary artery tortuosity.Material and methods 361 patients who underwent elective coronary angiography (CAG) due to CCS were included in the study. These patients divided into two groups, those with coronary tortuosity (Group 1) and those without (Group 2). Univariable and multivariable logistic regression analysis was performed to identify predictors associated with coronary artery tortuosity.Results The mean age of the 361 CCS patients (44 % female; 56 % male) was 56.7±11.5 years. In the univariable regression analysis, age, female sex, hypertension (HT), PR interval, QTc interval, ST / T segment changes, left ventricle diastolic dysfunction (LVDD), left ventricle hypertrophia (LVH) were identified as predictors of coronary tortuosity. In the multivariable regression analysis, age (OR: 1.059; 95 %CI: 1.032-1.087, p<0.001) and hypertension (OR: 0.484; 95 %CI: 0.278-0.843, p=0.01) were identified as independent predictors of coronary tortuosity.Conclusion Coronary artery tortuosity is an angiographic finding that develops as a result of adaptive mechanisms in the heart and can cause myocardial ischemia. Predictors of coronary artery tortuosity in patients with CCS were long PR and QTc intervals, ST / T segment changes, LVH, LVDD, advanced age, and female gender. Evaluation of these demographic, electrocardiographic, and echocardiographic data may help clinicans to anticipate coronary artery tortuosity in patients with CCS and to be precautious for PCI.
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