[Coronary artery anomalies and coronary disease: is there a relationship?].
BACKGROUND
It has been suggested that in coronary anomalies the turbulence of the flow might develop atherosclerosis, but this theory remains controversial. The relationship between coronary anomalies and coronary artery disease have been studied.


METHODS
Twenty-five patients [15 males, 10 females (mean age 75+/-1.4 years)] with coronary anomalies at coronary angiography were enrolled in a prospective study. Thirteen patients out of 25 (group 1) had critical coronary artery disease (>50% of reduction in luminal diameter). The anomalous vessels passing intramyocardial or between aorta and pulmonary veins were excluded. Twelve patients out of 25 had no sign of atherosclerosis (group 2). At clinical and instrumental follow-up (54+/-8.4 months) the number of cardiovascular events (acute myocardial infarct, unstable angina, silent ischemia, bypass or PTCA interventions, cardiovascular death) was evaluated in the two groups.


RESULTS
Age and ejection fraction value were no statistically different in the two groups. Risk factors were significantly (p<0.04) higher in group 1 (smoke, hypertension, hypercholesterolemia, diabetes). The patients number with cardiovascular events was significantly higher in group 1(11 patients vs 2) confirming the independence of the two phenomena. No correlation was found between presence of risk factors and presence of events. A correlation (r=0.70) was found only between previous coronary artery disease and number of events.


CONCLUSIONS
No relationship between coronary anomalies and coronary artery disease seems to be confirmed. The real relevance of flow turbulence in the development of atherosclerosis in coronary anomalies needs to be still confirmed.
Rigatelli
G
G
Dipartimento di Malattie Cardiovascolari, Emodinamica e Cardiologia Interventistica, Ospedale Generale di Legnago, Verona, Italy.
Gemelli
M
M
Franco
G
G
Bolomini
L
L
Docali
G
G
Rigatelli
G
G
D000368:Aged; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000209:etiology*; D003330:Coronary Vessel Anomalies / Q000150:complications* / Q000000981:diagnostic imaging; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors