Prevalence And Pattern Of Anomalous Origin Of Coronary Artery In Chinese Population

Objective: To investigate the prevalence and pattern of anomalous origin of coronary artery (AOCA) in Chinese population, and to compare the clinical value of coronary angiography (CAG) and computed tomography angiography (CTA) in the diagnosis of AOCA.Methods: Publications regarding the incidence of AOCA by CAG or CTA before October2013were extracted from China national knowledge infrastructure (CNKI), wanfang database and Chinese science&technology journal database. Meta Analysis was used to estimate the total frequency of AOCA and different types of AOCA were assessed to determine their incidence and constituent ratio respectively. The detection rates of AOCA between CAG and CTA were compared to explore their potential difference in the diagnosis of AOCA.Result:16papers were retrieved with a total sample of64204cases, among which AOCA was detected in677cases (1.05%). Anomalous origin of right coronary artery (RCA) from the left sinus of Valsalva was found to be the most common type of AOCA (38.40%), followed by separate origin of left anterior descending (LAD) and left circumflex (LCX) from the left sinus of Valsalva (18.91%). No statistically significant difference was found in the detection rates of AOCA between CAG and CTA, but the situation was reverse when it referred to a certain specific type of AOCA. Among all types of AOCA, CAG had a higher detection rate than CTA in separate origin of LAD and LCX from the left sinus of Valsalva, anomalous origin of RCA near the right sinus of Valsalva and anomalous origin of LAD and LCX from the ascending aorta; while in anomalous origin of LCA from the posterior sinus of Valsalva, anomalous origin of RCA from the ascending aorta, anomalous origin of LCA from the ascending aorta and anomalous origin of both RCA and LCA from the ascending aorta, the detection rate was relatively higher for CTA.Conclusions: The incidence of AOCA in a selected population of China is similar to ealier reports of other countries, but shares no similarity in the proportion of differntent patterns of AOCA. While the total detection rates of AOCA between CAG and CTA show no significant difference, potential advantages may exist for either screening method in specific types of AOCA.