The association between coronary arterial dominancy and extent of coronary artery disease in angiography and paraclinical studies.

The association between coronary arterial dominance patterns and the coronary artery diameter, length, and valvular heart diseases were previously studied. However, its association with coronary artery disease (CAD) is unclear. We investigated to determine whether the extent and localization of CAD differ in right, left, or codominant coronary arterial patterns. Twelve thousand five hundred fifty-eight patients admitted to Tehran Heart Center for coronary angiography were studied retrospectively (2004-2006). The extent and localization of CAD and the dominant artery were determined. There were 62.7% males. The mean age was 57.6 +/- 10.3. 84.2% [95% confidence interval (CI); 83.6-84.8%], 10.9% (95% CI; 10.4-11.4%), and 4.8% (95% CI; 4.4-5.2%) of the patients were right, left, and codominant, respectively; No significant difference considering age, sex, positive family history, hypertension, hyperlipidemia, electrocardiography, exercise treadmill stress test, and perfusion scan were seen in the groups. The right-dominant patients tend to have three-vessel disease (33.1% vs. 27%, P < 0.0001), stenosis of more than 50% in right coronary artery (65.9% vs. 57.9%, P < 0.0001) and left circumflex territories (64% vs. 59.4%, P = 0.01), more than the left-dominant patients. The involvements of the left main coronary artery, left anterior descending artery territory, and posterior descending artery were not significantly different. This study demonstrates a relationship between angiographic CAD severity, and the involved arterial territory and dominancy patterns. (c) 2008 Wiley-Liss, Inc.