The relationship between coronary artery bifurcation angle and take-off angle origin with degree of stenosis and Calcium Score in coronary artery disease patients

BACKGROUND: Coronary artery disease (CAD) is associated with the formation of atherosclerotic plaques influenced by systemic risk factors. Anomalies in the coronary arteries origin can cause sudden cardiac death. Coronary computed tomography angiography (CTA) is used to evaluate plaque distribution, calcium scores, stenosis, and coronary artery origin anomalies. The aim of this study was to determine the relationship between coronary artery bifurcation angle and the take-off angle of the left main coronary artery (LMA) origin with the degree of stenosis and Calcium Score in CAD patients using multislice CT coronary angiography (MSCTA; MSCTA Cardiac).METHODS: This retrospective study were conducted from January to December 2023, included CAD patients who underwent MSCTA Cardiac at our center. Statistical analyses were performed using SPSS v25.0, with significance set at P value of ≤0.05.RESULTS: A total of 36 samples were analyzed. The mean LMA- left anterior descending (LAD) bifurcation angle was 139.72±22.82°, LMA- left circumflex (LCx) was 130.88±22.35°, LAD-LCX was 66.62±23.82°, and the LMA take-off angle was 82.46±20.24°. A greater LMA-LAD bifurcation angle correlated with increased LMA stenosis (r=0.341, P=0.042), while a greater LMA take-off angle was associated with decreased LMA stenosis (r=-0.390, P=0.019). Additionally, smoking was found to increase the Calcium Score of the LAD (P=0.008), and diabetes mellitus exacerbated LAD stenosis (P=0.016).CONCLUSIONS: The study identified a significant correlation between the LMA-LAD bifurcation angle and the take-off angle of the LMA origin with the degree of LMA stenosis. Smoking and diabetes were also found to negatively impact the coronary arteries, increasing calcium scores and stenosis, respectively.