Comparison of Clinical and Angiographic Findings between Stable Angina Patients with and without Coronary Tortuosity

Many factors may have an important role in coronary artery disease (CAD). These factors may lead to coronary artery stenosis. Some patients do not have any plaque or stenosis in angiography but have chest pain and angina. This problem is called X syndrome. Although the causes of X syndrome are unknown, some believe that coronary tortuosity might be responsible for angina. The aim of this study was to understand the relation between coronary tortuosity and chest pain. This was a case-control study performed in Isfahan hospitals, Iran during 2010-2011. The patients candidate for coronary angiography were selected and divided into two groups based on coronary tortuosity. Demographic information, risk factors, angiographic findings and Gensini scores were collected and compared. All analyses were conducted in SPSS18. Overall, 15% of all patients had coronary tortuosity. Among clinical signs, CCS class and functional class significantly differed between the two groups. The prevalence of the mentioned symptoms was also different between the groups. The mean Gensini index was lower in the case group. Stenosis in left anterior descending artery (LAD), left circumflex artery (LCX), right ventricular apex (RVA), obtuse marginal (OM), and left main coronary artery (LM) were different between the two groups. There were many differences between tortuous and non-tortuous groups in demographic characteristics, risk factors and angiographic findings. Thus, tortuosity may lead to signs and symptoms due to epicardial coronary stenosis.