未经证实:本研究试图在被诊断为冠状动脉异常主动脉起源(AAOCA)的成年人中描述冠状动脉疾病(CAD)的特征。我们假设起源异常的冠状动脉比起源正常的冠状动脉具有更严重的CAD狭窄。
UNASSIGNED:这项针对763名AAOCA成年人的单中心研究包括来自我们的心脏导管插入数据库(1958-2009)的620名患者和来自电子病历查询(2010-2021)的273名患者。在左主内,前降,回旋,和右冠状动脉,CAD狭窄严重程度,通过侵入性或计算机断层扫描血管造影评估,用冠状动脉水平变量(存在异常起源)和患者水平变量(年龄,性别,合并症,以及四个冠状动脉中哪一个异常)。
未经证实:在763名患者中,472(60%)患有阻塞性CAD,谁,142/472(30%)仅在异常冠状动脉中患有阻塞性CAD。多变量模型显示异常起源与正常起源之间的CAD狭窄严重程度相似(P=.8)。与其他冠状动脉的AAOCA相比,异常回旋在年龄较大时被诊断出(59.7±11.1vs54.3±15.8岁,P<0.0001),并与所有冠状动脉狭窄增加相关(比值比,2.7;95%置信区间,2.2-3.4,P<.0001)。
未经证实:在被诊断为AAOCA的成年人中,异常起源似乎并未增加异常冠状动脉内CAD的严重程度.与回旋相反,当其他血管的AAOCA在较年轻的CAD较少的年龄出现症状时,它们可能会造成更大的缺血负担。未来的研究应该调查AAOCA之间的相互作用,CAD,和缺血性风险指导干预。
UNASSIGNED: This study sought to characterize coronary artery disease (CAD) among adults diagnosed with an anomalous aortic origin of a coronary artery (AAOCA). We hypothesized that coronaries with anomalous origins have more severe CAD stenosis than coronaries with normal origins.
UNASSIGNED: This single-center study of 763 adults with AAOCA consisted of 620 patients from our cardiac catheterization database (1958-2009) and 273 patients from electronic medical records query (2010-2021). Within left main, anterior descending, circumflex, and right coronary arteries, the CAD stenosis severity, assessed by invasive or computer tomography angiography, was modeled with coronary-level variables (presence of an anomalous origin) and patient-level variables (age, sex, comorbidities, and which of the four coronaries was anomalous).
UNASSIGNED: Of the 763 patients, 472 (60%) had obstructive CAD, of whom, 142/472 (30%) had obstructive CAD only in the anomalous coronary. Multivariable modeling showed similar CAD stenosis severity between coronaries with anomalous versus normal origins (P = .8). Compared with AAOCA of other coronaries, the anomalous circumflex was diagnosed at older ages (59.7 ± 11.1 vs 54.3 ± 15.8 years, P < .0001) and was associated with increased stenosis in all coronaries (odds ratio, 2.7; 95% confidence interval, 2.2-3.4, P < .0001).
UNASSIGNED: Among adults diagnosed with AAOCA, the anomalous origin did not appear to increase the severity of CAD within the anomalous coronary. In contrast to the circumflex, AAOCA of the other vessels may contribute a greater ischemic burden when they present symptomatically at younger ages with less CAD. Future research should investigate the interaction between AAOCA, CAD, and ischemic risk to guide interventions.