Clinical Significance of Coronary Artery Tortuosity in Chronic Coronary Syndrome and Stable Angina: Insights from Gensini Scores

OBJECTIVE
This study investigated the clinical significance of coronary artery tortuosity (CAT) in chronic coronary syndrome (CCS) using Gensini scores.


METHOD
This retrospective single-center study involved 388 patients undergoing coronary angiography for chest pain, excluding those with acute coronary syndromes or prior coronary interventions. Demographic, clinical, and angiographic data were collected and categorized based on the presence or absence of CAT.


RESULTS
Analysis of 388 patients revealed that CAT was associated with older age (P < 0.001), female gender (P < 0.001), lower rates of smoking (19.3% vs. 29.6%, P = 0.025), and hypertension (53.5% vs. 38.7%, P = 0.05). There was a slightly higher, nearly significant, prevalence of diabetes in the CAT group (22.8% vs. 14.5%, P = 0.051). Furthermore, CAT correlated with diastolic dysfunction (P = 0.04) and was inversely related to the severity of coronary atherosclerosis, as indicated by lower Gensini scores correlating with higher CAT scores (P = 0.039 and P = 0.049, respectively). Univariate analysis confirmed CAT’s association with older age (P < 0.001), female gender (P < 0.001), hypertension (P = 0.004), diabetes (P = 0.039), diastolic dysfunction (P = 0.003), and Gensini score (P = 0.012). Multivariate analysis further identified significant correlations with age (P = 0.001), female gender (P < 0.001), and Gensini score (P = 0.049).


CONCLUSION
Our findings indicate that older age and female gender predict presence of CAT in CCS patients. The lower Gensini scores associated with CAT may possibly be due to a reduced atherosclerotic plaque burden in these patients. Further research into this relationship could inform the development of treatment and management strategies for coronary atherosclerosis.