Author + information
The purpose of this study is to investigate the relationship between right coronary dominance and multi-branch artery stenosis in patients with significant coronary artery disease (sCAD).
In this cross-sectional study, 1654 patients with sCAD (1236 males, 418 females) were evaluated with coronary angiography (CAG). The phynotype of coronary artery dominance was then divided into left dominance, right dominance and co-dominance based on CAG reports. Significant CAD was defined as ≥50% luminal narrowing in at least one of the epicardial coronary arteries. Multi-branch artery stenosis refers to two or three coronary arteries with significant luminal narrowing. Descriptive statistics are presented as percentages for discrete variables and as means (standard deviation) for continuous variables. Multivariate logistic regression was used to examine the relationship between artery stenosis and clinical parameters.
In our study, a total of 1500 patients (90.6%) with sCAD present right dominance. Left dominance was observed in 110 (6.7%) individuals and codominance in 44 patients (2.7%). Patients with right dominance had a lowest incidence of single artery stenosis, while they are more prone to have a highest prevalence of multi-branch artery stenosis (P<0.01). After multivariate logistic regression analysis, right dominance (OR 1.476; 95%CI 1.032-2.110; p=0.033), age (OR 1.031; 95%CI 1.020-1.043; p<0.001), smoking (OR 1.594; 95%CI 1.265-2.008; p<0.001), diabetes (OR 1.527; 95%CI 1.001-2.328; p=0.049) and hypertension (OR 1.311; 95%CI 1.036-1.661; p=0.024) were significantly associated with the prevalence of multi-branch arteries stenosis.
Right coronary dominance may serve as a risk factor for multivessel coronary vascular lesions in patients with sCAD. Therefore, the assessment of coronary vessel dominance with CAG may further improve the risk stratification beyond the assessment of coronary stenosis.