Left anterior descending coronary artery‐left circumflex coronary artery bifurcation angle and severity of coronary artery disease; is there any correlation? A cross‐sectional study

Background and Aims The aim of this study is to evaluate the association of coronary computed tomography angiography derived (CCTA) plaque characteristics and the left anterior descending coronary artery (LAD) and left circumflex coronary artery (LCX) bifurcation angle with severity of coronary artery disease (CAD). Methods All the stable patients with suspected CAD who underwent CCTA between January to December 2021 were included. Correlation between CCTA‐derived aggregated plaque volume (APV), LAD‐LCX angle, remodeling index (RI), coronary calcium score with Gensini score in conventional angiography were assessed. One hundred and twenty‐two patients who underwent both CCTA and coronary angiography were analyzed. Results Our analysis showed that the median (percentile 25% to percentile 75%) of the APV, LAD‐LCx angle, and calcium score were 31% (17%−47%), 58° (39°−89°), and 31 (0−186), respectively. Also, the mean ± SD of the RI was 1.05 ± 0.20. Significant correlation between LAD‐LCx bifurcation angle (0.0001−0.684), APV (0.002−0.281), RI (0.0001−0.438), and calcium score (0.016−0.217) with Gensini score were detected. There was a linear correlation between the mean LAD‐LCx bifurcation angle and the Gensini score. The sensitivity and specificity for the cut‐off value of 47.5° for the LAD‐LCX angle were 86.7% and 82.1%, respectively. Conclusion There is a direct correlation between the LAD‐LCx angle and the Gensini score. In addition to plaque characteristics, anatomic‐based CCTA‐derived indices can be used to identify patients at higher risk for CAD.