Anatomical variants of coronary arteries in computed tomography angiography: prevalence in patients of the General Hospital of Mexico
DOI:
https://doi.org/10.62407/p50rb434Abstract
Coronary computed tomography angiography (CCTA) is the noninvasive reference modality for comprehensive evaluation of coronary anatomy. Objective: This study aimed to determine the prevalence of coronary artery variants identified via CCTA and assess their clinical association with myocardial ischemia in a Mexican patient cohort. Methodology: An observational, descriptive, retrospective, cross-sectional study was conducted in patients who underwent coronary computed tomography angiography at the Hospital General de México between March and November 2025. Demographic variables, the presence of coronary anatomical variants, and clinical data compatible with myocardial ischemia were analyzed. Ischemia-related data were defined based on the clinical diagnosis and the indication for referral documented in the radiology record. Descriptive statistics were used, and associations were evaluated using the chi-square test of independence. Results: A total of 88 studies were analyzed, with a mean age of 54 ± 19 years; 51.4% of the patients were female. Coronary anatomical variants were identified in 28.41% of cases. The most frequent variants were the presence of a ramus intermedius (36%), left coronary dominance (36%), myocardial bridging (20%), and left-sided origin of the right coronary artery (8%). Clinical data compatible with myocardial ischemia were present in 57% of patients. A statistically significant association was observed between the presence of coronary anatomical variants and ischemia-related clinical data (p = 0.034), with no significant association with sex (p = 0.058). Procedure-related complications were infrequent (2.91%) and were limited to contrast medium infiltration. Conclusions: The prevalence of coronary anatomical variants in this Mexican population was higher than that reported in the international literature. Coronary computed tomography angiography proved to be a safe and effective diagnostic tool for their identification. The observed association between anatomical variants and clinical data compatible with myocardial ischemia underscores their clinical relevance and highlights the need for systematic recognition in routine clinical practice.
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