Investigation of the Relationship between Right Coronary Artery–Aorta Angle and Coronary Artery Disease and Associated Risk Factors

Abstract

At the level of the left coronary artery tree, there is evidence showing an association between bifurcation angle and coronary artery disease (CAD), and this motivated us to explore similar associations at the level of the right coronary artery (RCA). The purpose of this study was to determine whether there is a relationship between RCA–aorta angle and CAD and age, sex, body mass index, smoking status, hypertension, and high blood cholesterol. The coronary computed tomography angiography datasets and CAD risk factor checklists of 250 patients were retrospectively reviewed, with RCA–aorta angles measured via multiplanar reformation images. Independent t-tests were used to compare mean RCA–aorta angle measurements between groups, correlations between continuous variables were assessed using Pearson and Spearman correlations, and a general linear model was used to adjust for potentially confounding variables. Coronary angle measurements were conducted by two independent assessors with very strong intraclass correlation (r=0.999, p<0.001). A significantly smaller mean RCA–aorta angle was observed in the CAD group (79.07 ± 24.88°) compared to the normal group (92.08 ± 19.51°, p=0.001), in smokers (76.63  ± 22.94°) compared to non-smokers (85.25  ± 23.84°, p=0.016), and a narrow RCA–aorta angle was negatively correlated with BMI (r=−0.174, p=0.010). This study suggests a relationship between narrow RCA–aorta angles and CAD, smoking, and increasing BMI.