Key result
Right coronary dominance linked to ~140% higher acute inferior MI risk versus left or co-dominance.
Why the study?
Left coronary artery dominance has been linked to worse prognoses in acute coronary syndrome, but whether coronary dominance is associated with the incidence of acute inferior MI remained uninvestigated.
Is right coronary dominance associated with an increased incidence of acute inferior myocardial infarction compared to left or co-dominance?
Case-Control (n=795)
No
Is right coronary dominance associated with an increased incidence of acute inferior myocardial infarction compared to left or co-dominance?
Right coronary dominance is independently associated with a higher risk of developing acute inferior myocardial infarction compared to left or co-dominant anatomies.
Answers are grounded in this paper and cite their sources.
Right dominance was associated with acute inferior MI incidence; leaves open causal role and needs prospective validation before clinical consideration.
BACKGROUND: Previous studies have found a connection between left coronary artery dominance and worse prognoses in patient with acute coronary syndrome, which remains a predominant cause of morbidity and mortality globally. The aim of this study was to investigate whether coronary dominance is associated with the incidence of acute inferior myocardial infarction (MI). METHODS: Between January 2011 and November 2014, 265 patients with acute inferior MI and 530 age-matched and sex-matched controls were recruited for a case-control study in the Second Affiliated Hospital of Xi'an Jiaotong University in Xi'an, China. All participants underwent coronary angiography. The exclusion criteria included history of coronary artery bypass graft surgery, chronic or systemic diseases (including hepatic failure, kidney failure, hypothyroidism and Grave's disease), ventricular fibrillation, and known allergy to iodinated contrast agent. Patients with left- or co-dominant anatomies were placed into the LD group and those with right-dominant anatomy were included in the RD group. The association of acute inferior MI and coronary dominant anatomy were assessed using multivariable conditional logistic regression, and to estimate the odds ratio (OR) and 95% confidence interval (95%CI). RESULTS: Distributions of right dominance were significantly different between the acute inferior MI group and control group (94.0% vs. 87.9%, P = 0.018). Univariable conditional logistic regression revealed that right dominance may be a risk factor for the incident acute inferior MI (OR: 2.137; 95% CI: 1.210-3.776; P = 0.009). After adjusting for baseline systolic blood pressure, heart rate, smoking status, diabetes mellitus, hypertension, hyperlipidaemia, and family history of coronary artery disease, results of multivariate conditional logistic regression showed that right dominance was associated with the incidence of acute inferior MI (OR: 2.396; 95% CI: 1.328-4.321; P = 0.004). CONCLUSIONS: Right coronary dominance may play a disadvantageous role in the incidence of acute inferior MI. However, further studies are needed to verify our findings, especially with regard to the underlying mechanisms.
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Wang et al. (2019) conducted a case-control in Acute inferior myocardial infarction (n=795). Right coronary dominance vs. Left or co-dominant coronary anatomy was evaluated on Incidence of acute inferior myocardial infarction (OR 2.396, 95% CI 1.328-4.321, p=0.004). Right coronary dominance was significantly associated with an increased incidence of acute inferior myocardial infarction compared to left or co-dominance (OR 2.396).
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