Analysis of coronary artery anomalies in adults: morphology, atherosclerosis, and cardiovascular risks

Aims: Despite their rarity, coronary artery anomalies (CAAs) warrant careful consideration during percutaneous or surgical interventions due to their potential influence on clinical outcomes. The objective of this study was to ascertain the prevalence and characteristics of CAAs in adult patients undergoing coronary angiography. Methods: A retrospective analysis was conducted on 12.457 coronary angiography records from a tertiary hospital, encompassing the period from May 2007 to October 2010. The classification of anomalies adhered to the system proposed by Dr. Angelini and approved by the Congenital Heart Surgery Committee. Statistical comparisons were performed through the application of Student’s t-test, Pearson’s chi-square test, and Fisher’s exact test. Results: An analysis of angiographies identified CAAs in 134 cases, consisting of 89 males and 45 females, with an age range spanning from 21 to 87 years . Myocardial bridging was identified in 62 instances (0.49%), coronary artery exit anomalies in 17 instances (0.14%), coronary artery aneurysms in 30 instances (0.24%), coronary artery fistula in 18 instances (0.14%) , and coronary artery atresia in one instance (0.01%). There were no substantial gender variations observed among the different types of anomalies. Conclusion: The findings of this study align closely with previous research concerning the prevalence and characteristics of CAAs. Prompt diagnosis and angiographic assessment of congenital CAAs are essential for optimal management and minimizing procedural risks. Anatomical knowledge is indispensable in elucidating pathophysiological mechanisms, optimizing surgical strategies, and advancing diagnostic imaging techniques.