The Relationship Between the Aortic Angle of the Right Coronary Artery and the Bifurcation Angle of the Left Main Coronary Artery With Coronary Artery Disease.

Background: The literature contains a few studies that explore the possibility of assessing coronary artery disease (CAD) risk based on the angle between the coronary arteries and the bifurcation of the aorta.

Purpose: To reveal the relationship between the angle of the right coronary artery and the aorta, as well as the bifurcation angle of the left main coronary artery, with the degree of plaque and stenosis in the right coronary artery, left main coronary artery, left anterior descending artery (LAD), and circumflex artery (Cx).

Materials and methods: The coronary CT angiographies of 217 patients, taken due to suspected CAD at our institution between October 2023 and June 2024, were retrospectively evaluated. All CT images were analyzed at different times by two experienced radiologists using a specialized workstation. There was significant concordance between intraobserver and interobserver assessments. Multiplanar reconstruction (MPR) was performed to measure the angles.

Results: The mean LAD-Cx angle measured by the first radiologist was 78.81 ± 30.54, while the second radiologist's measurement was 79.34 ± 30.62, demonstrating excellent agreement. The mean right coronary artery-aortic (RCA-Aortic) angle measured by the first radiologist was 96.21 ± 33.47, while the second radiologist's measurement was 96.75 ± 33.62, again demonstrating excellent agreement.

Conclusion: In this study, no association was found between coronary artery angles and the presence of plaque or stenosis. Therefore, coronary artery angles should not be considered a reliable indicator of CAD risk. Instead, risk assessment should include other well-established risk factors.