Anomalous origin of the right coronary artery from the left coronary sinus is associated with early development of coronary artery disease.
BACKGROUND
Anomalous origin of the right coronary artery (RCA) from the left coronary sinus can cause sudden cardiac death. Whether this unique anatomical defect also predisposes to early development of coronary artery disease (CAD) remains uncertain.


METHODS
Demography, cardiovascular risk factor profiles and coronary angiograms were reviewed in 1,532 consecutive patients over the past 3 years.


RESULTS
Thirteen patients (0.8%) had anomalous RCA from the left coronary sinus, while the rest had normal origin from the right coronary sinus. CAD was found in 9/13 anomalous RCA patients (group A) and in 795/1,519 patients with normal RCA origin (group B). There were no differences in the distributions of age, sex or cardiovascular risk factors between the two groups. The distribution of critical lesions among the 3 major coronary arteries showed no significant differences either. However, among the patients with RCA involvement, the anomalous RCA group was significantly younger (54.8 +/- 4.8 years versus 64.9 +/- 10.1 years; p = 0.022).


CONCLUSIONS
The anomalous RCA from left coronary sinus is associated with early development of CAD. The affected patients are 10 years younger.
Jim
Man-Hong
MH
Department of Medicine, Queen Mary Hospital, Pokfulam Road, Hong Kong. jimmanh2002@yahoo.com
Siu
Chung-Wah
CW
Ho
Hee-Hwa
HH
Miu
Ramond
R
Lee
Stephen Wai-Luen
SW
D001011:Aorta; D006328:Cardiac Catheterization / Q000379:methods; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000209:etiology*; D003330:Coronary Vessel Anomalies / Q000150:complications*; D016757:Death, Sudden, Cardiac / Q000209:etiology; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors