Background: Despite the recognition of the common risk factors for coronary artery disease (CAD), it
appears that there is a wider range of risk factors. The purpose of the present study was to
evaluate the association between the anatomical factors and the increased risk of CAD
occurrence and its clinical consequences.
Methods: in this study, 50 cases with a single coronary artery stenosis of the left anterior descending
artery (LAD) and 50 controls with a normal coronary angiography or non-obstructive CAD
were enrolled, and the objective of the study was compared between the 2 groups.
Results: The number of the branches before the LAD stenosis significantly increased in the patients
with LAD disease, and there was a meaningful increase in the number of both the diagonal and
septal branches originating before the stenosis (P<0.001). The average number of the diagonal
branches was the same in both groups, which was statistically insignificant. (P=0.986) The
mean value of the angle between the largest diagonal branch or septal branch and the LAD in
the cases with CAD and the controls showed no significant difference. A family history of the
early-onset cardiovascular disease in the control group with non-obstructive CAD was 6%
versus 20% in the CAD group, and this difference was statistically significant (P≤0.03).
Conclusions: According to our study, it appears that the sum of the septal and diagonal branches of the
LAD can be a statistically significant risk factor for the progression of atherosclerosis in the
LAD as well. The LAD involvement is significantly associated with the familial type of CAD