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According to the blood supply of the posterior interventricular septum, coronary circulation is categorized as right dominance (RD), left dominance (LD), and co-dominance (CD). In this study, the relationship between coronary dominance and angiographic gensini score in patient with significant coronary artery disease (sCAD) was investigated.
A total of 1654 patients with sCAD (1235 males, mean age 59.4±10.3 years) were evaluated with coronary angiography (CAG). Significant CAD was defined as ≥ 50% luminal narrowing in at least one of the epicardial coronary arteries. Patients included in the study were finally divided into 2 groups, based on a diagnostic CAG. Patients with left- or co-dominant anatomies were placed into the LD group and those with right-dominant anatomy were included in the RD group. The angiographical severity of sCAD was evaluated using gensini score.
In our study, there was no significantly statistic difference between the RD group and LD group in demographic characteristics and CAD risk factors. After assessment of gensini score, there was remarkable significance between RD group and LD group in total gensini score (42.3±33.6 vs. 36.3±29.8; p=0.033), gensini score of right coronary artery (7.8±10.8 vs. 4.7±8.5; p=0.001) and gensini score of posterior descending artery (0.5±1.9 vs. 0.2±1.3; p=0.008). Furthermore, RD group had a higher prevalence of patient with gensini score>25 than LD group (59.9% vs. 51.3%; p=0.038).
Coronary artery dominance may be associated with the severity of CAD. Patient with right dominance tends to have more severe coronary artery atherosclerosis than left dominance and co-dominance.