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The aim of this case-control study was to evaluate the association between coronary dominance and acute coronary syndrome (ACS).
In this hospital-based case-control study, 1010 ACS patients and 1010 age-and sex-matched controls were recruited in Northern Chinese population. All the patients were undergoing coronary angiography while demography, clinical variables, diagnosis and medical history were collected. ACS includes ST-elevation myocardial infarction, non ST-elevation myocardial infarction, and unstable angina. The phynotype of coronary artery dominance was divided into left dominance, right dominance and co-dominance based on CAG reports. Logistic regression analysis was used to estimate the odds ratios (OR) and 95% confidence intervals (95%CI) for relationship between coronary dominance and ACS.
In our study, a total of 930 patients (92.1%) present right dominance in ACS group while left dominance was observed in 54 (5.3%) individuals and codominance in 26 patients (2.6%). The prevalence of right dominance was significantly lower in control subjects (851 patients, 84.3%). After adjustment for potential confounding factors, multivariate logistic regression analysis showed that right dominance (OR 1.513; 95%CI 1.127-2.031; p=0.006) was associated with the occurrence of ACS.
These results suggest right coronary dominance may play a disadvantageous role in the incidence of ACS. However, further studies are needed to provide more evidence, especially with regard to the underlying mechanisms.