The relation between coronary tortuosity and calcium score in patients with chronic stable angina and normal coronaries by CT angiography

- Patients with stable angina and normal coronaries in CT angiography were divided into tortuous and non-tortuous groups.
- There was a highly significant difference between both groups regarding hypertension and smoking habits.
- There was a significant difference between both groups in coronary calcium score with higher score in the tortuous group.
- There was significant correlation between tortuosity and calcium score if adjusted for co-variated affecting tortuosity.

PurposeCoronary tortuosity (CorT) is a phenomenon often noticed by cardiologists and may be associated with stable angina even without significant lesion. We aim to determine the relationship between CorT and coronary artery calcium (CAC) scoring in patients with chronic stable angina and normal or near normal coronaries detected by computed tomography (CT) angiography.MethodsThis is a cross sectional retrospective study included all patients with stable angina underwent CT coronary angiography and calcium scoring that reveals normal or non-significant coronary artery lesion. The presence of CorT was revised. CorT is defined as a fixed ≥3 bends during both systole and diastole, with each bend ≥45°.ResultsThe study involved 83 patients. CT angiography revealed 31 patients (37.3%) with tortuous one or more coronary arteries and 52 patients (62.7%) without any CorT. The patients were divided into 2 groups; those patients with tortuous coronary arteries (CorT group) and those without coronary tortuosity (N CorT group). There was no significant difference between both groups regarding age, presence of DM, and dyslipidemia. However, there was a highly significant difference between both groups regarding hypertension with more hypertension among the CorT group (p value < 0.001). There was a significant difference between both groups in CAC score with high CAC score in the CorT group (p value < 0.05). There was significant correlation between CorT and CAC score (unadjusted p = 0.06); if adjusted for co-variated affecting CorT (p = 0.022).ConclusionCorT is associated with subclinical atherosclerosis and increased CAC score even in the absence of significant obstructive lesion.