QUANTITATIVE CORONARY ANGIOGRAPHIC ASSESSMENT OF SEGMENT-SPECIFIC CORONARY ARTERY MORPHOMETRY IN CORONARY ARTERY DISEASE: A HOSPITAL-BASED CASE–CONTROL STUDY
TL;DR
QCA showed segment-dependent differences in coronary caliber and geometry, although the pattern was less extensive after correction for multiple comparisons, and should not be interpreted as CAD-specific effects independent of these potential confounders.
Abstract
Objectives: The objective of the study was to compare segment-specific coronary artery morphometry between patients with angiographically confirmed coronary artery disease (CAD) and individuals with normal or near-normal coronary arteries using quantitative coronary angiography (QCA). Methods: This hospital-based case–control study included 200 adults aged 30–60 years who underwent clinically indicated coronary angiography, comprising 100 patients with angiographically confirmed CAD and 100 angiographic controls. The controls were symptomatic patients referred for angiography whose coronary arteries were normal or near-normal without significant luminal obstruction; they were not healthy volunteers. Angiograms were analysed offline using the CAAS Workstation (version 8.5.1). Eight QCA parameters were compared across six prespecified coronary territories. Because 48 segment-parameter comparisons were examined, unadjusted p-values are reported together with a Bonferroni sensitivity threshold of p≤0.00104. Results: The controls were older than the CAD cases (55.87±4.78 vs. 52.15±6.55 years; p=0.002). Several nominal between-group differences were observed, but only a smaller subset remained robust after correction for multiplicity. In the downstream right posterior descending artery (PDA), lesion diameter, percentage diameter stenosis, reference diameter, maximum diameter, proximal diameter (Dprox), and distal diameter met the Bonferroni threshold (p≤0.001). In the left circumflex artery, Dprox met the corrected threshold (p=0.001), and in the left PDA, lesion diameter remained significant (p<0.001). Other findings with p-values between 0.00104 and 0.05 were considered nominal. Several measures showed wide standard deviations, indicating substantial within-group variability. Conclusion: QCA showed segment-dependent differences in coronary caliber and geometry, although the pattern was less extensive after correction for multiple comparisons. Because the analyses were not adjusted for age, sex, cardiovascular risk factors or body surface area, the observed associations should be considered exploratory and should not be interpreted as CAD-specific effects independent of these potential confounders.