Incidence of Abnormal Coronary Artery Departures in Working-Age Patients with Ischemic Heart Disease

This paper investigates the prevalence of anomalous coronary artery origins among working-age individuals suffering from coronary artery disease, utilizing data from percutaneous coronary interventions. The research was conducted at the Samarkand Regional Branch of the Republican Specialized Scientific and Practical Medical Center of Cardiology over a one-year period from January to December 2024. A total of 4,170 coronary angiographic examinations were performed in patients with suspected or confirmed CAD. Among these individuals, 35 patients were identified as having anomalous origins of the coronary arteries, corresponding to a prevalence of approximately 0.84% within the studied population. The study population primarily consisted of working-age individuals, highlighting the socio-economic importance of early detection and appropriate management of such anomalies. Coronary angiography was used as the primary diagnostic modality to identify and classify the anatomical variants. The analysis revealed a diverse spectrum of coronary artery anomalies. The most frequently observed anomaly was the circumflex artery (CA) originating from the right coronary artery (RCA), identified in 12 patients (34.3%). The second most common finding was the origin of the RCA from the aorta above the sinus of Valsalva, observed in 9 patients (25.7%). In 6 cases (17.1%), the RCA originated from the left sinus of Valsalva. Less frequent anomalies included the obtuse marginal (OB) artery originating from the right sinus of Valsalva in 4 patients (11.4%) and the left anterior descending artery (LAD) originating from the RCA in 3 patients (8.6%). A single rare case (2.9%) of a solitary coronary artery was also documented. In conclusion, anomalous coronary artery origins, while uncommon, are not rare among working-age patients with coronary artery disease. Awareness of their prevalence and anatomical variations is crucial for interventional cardiologists, as it facilitates accurate diagnosis, optimizes procedural strategies, and may reduce the risk of procedural complications. Further studies are warranted to evaluate the long-term clinical outcomes and prognostic significance of these anomalies in patients undergoing PCI.