Prognostic value of coronary vessel dominance in relation to significant coronary artery disease determined with non-invasive computed tomography coronary angiography

Veltman, Caroline E.; Graaf, Fleur R. de; Schuijf, Joanne D.; Werkhoven, Jacob M. van; Jukema, J. Wouter; Kaufmann, Philipp A.; Pazhenkottil, Aju P.; Kroft, Lucia J.M.; Boersma, Eric; Bax, Jeroen J.; Schalij, Martin J.; Wall, Ernst E. van der

doi:10.1093/eurheartj/ehs034

Cited by 58 publications

(55 citation statements)

References 24 publications

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“…A coronary artery system was classified as right dominant when the PDA originated from the right coronary artery (RCA), while left dominance was defined when the PDA originated from the left circumflex artery (LCX). A balanced dominant coronary system was categorised when the PDA rose from the RCA in combination with a large posterolateral branch originating from the LCX reaching near the posterior interventricular groove 2 . Right and balanced were referred to as non-left dominance.…”

Section: Angiographic Assessment Of Coronary Artery Dominancementioning

confidence: 99%

“…A few registries and studies have shown relations between left dominance and inferior clinical outcome [2][3][4] , but the patient populations of these studies differed significantly from that of the TWENTE trial 5 .…”

Section: Clinical Outcomementioning

confidence: 99%

“…Left coronary artery dominance is a variant of the normal coronary anatomy, in which the left circumflex artery reaches the crux and supplies both posterior descending and posterolateral branches 1,2 .…”

Section: Introductionmentioning

confidence: 99%

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Coronary artery dominance and the risk of adverse clinical events following percutaneous coronary intervention: insights from the prospective, randomised TWENTE trial

et al. 2015

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Aims: To investigate the prognostic value of coronary dominance for various adverse clinical events following the implantation of drug-eluting stents. Methods and results:We assessed two-year follow-up data of 1,387 patients from the randomised TWENTE trial. Based on the origin of the posterior descending coronary artery, coronary circulation was categorised into left and non-left dominance (i.e., right and balanced). Target vessel-related myocardial infarction (MI) was defined according to the updated Academic Research Consortium (ARC) definition (2x upper reference limit of creatine kinase [CK], confirmed by CK-MB elevation), and periprocedural MI (PMI) as MI ≤48 hours following PCI. One hundred and thirty-six patients (9.8%) had left and 1,251 (90.2%) non-left dominance. Target lesions were more frequently located in dominant arteries (p<0.005). Left dominance was associated with more severe calcifications (p=0.006) and more bifurcation lesions (p=0.031). Non-left dominance tended to be less frequent in men (p=0.09

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Section: Angiographic Assessment Of Coronary Artery Dominancementioning

confidence: 99%

Section: Clinical Outcomementioning

confidence: 99%

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Coronary artery dominance and the risk of adverse clinical events following percutaneous coronary intervention: insights from the prospective, randomised TWENTE trial

et al. 2015

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“…Most of the time a PL is supplied by LCX and PDA by RCA. 2 There are studies showing peri-procedural myocardial infarction and adverse outcomes in those patients who have left dominance. [2][3][4] The studies mainly assessed procedural outcomes in patients undergoing percutaneous coronary interventions (PCI).…”

Section: Introductionmentioning

confidence: 99%

“…2 There are studies showing peri-procedural myocardial infarction and adverse outcomes in those patients who have left dominance. [2][3][4] The studies mainly assessed procedural outcomes in patients undergoing percutaneous coronary interventions (PCI). There is limited knowledge about the relation between coronary dominance patterns and the risk of various adverse clinical events that can occur following coronary angiography in Nepal.…”

Section: Introductionmentioning

confidence: 99%

Coronary dominance and predictors of adverse events during coronary interventional procedures: an observational study

et al. 2017

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Coronary dominance and prognosis in patients with chronic total occlusion treated with percutaneous coronary intervention

Gebhard

Gick

Ferenc

et al. 2017

Cathet Cardio Intervent

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Aim The prognostic value of coronary artery dominance pattern in patients with chronic total occlusions (CTO) is unknown. The aim of this study was to assess the influence of coronary vessel dominance on short and long‐term outcomes in patients undergoing percutaneous coronary intervention (PCI) for CTO. Methods and results Our study population consisted of 2002 consecutive patients (17% females, mean age 65.2 ± 10.7 years) who underwent PCI of at least one coronary CTO lesion at our center between 01/2005 and 12/2013. Based on the origin of the posterior descending coronary artery, coronary circulation was categorised into left, right, and balanced coronary dominance. Right coronary dominance (RD) was present in 88% (n = 1759), left coronary dominance (LD) in 7% (n = 136), and balanced coronary dominance (BD) in 5% (n = 107) of the study population. After a median follow‐up duration of 2.6 years [interquartile range 1.1–3.1 years] all‐cause mortality was significantly higher in patients with LD as compared with RD and BD (log rank = 0.001). Accordingly, the presence of a LD system was identified as a significant predictor for all‐cause mortality (adjusted HR 1.7, 95% CI: 1.2‐2.6, P = .007) and major adverse cardiac events (MACE) (adjusted HR 1.4, 95% CI: 1.1‐1.8, P = 0.02). Conclusion Our data suggest that LD is an independent predictor of increased all‐cause death and MACE in patients with CTO. Therefore, assessment of coronary vessel dominance by angiography may contribute to risk stratification in these patients.

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Prognostic value of coronary vessel dominance in relation to significant coronary artery disease determined with non-invasive computed tomography coronary angiography

Cited by 58 publications

References 24 publications

Coronary artery dominance and the risk of adverse clinical events following percutaneous coronary intervention: insights from the prospective, randomised TWENTE trial

Coronary artery dominance and the risk of adverse clinical events following percutaneous coronary intervention: insights from the prospective, randomised TWENTE trial

Coronary dominance and predictors of adverse events during coronary interventional procedures: an observational study

Coronary dominance and prognosis in patients with chronic total occlusion treated with percutaneous coronary intervention

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