# Prevalence and Patterns of Congenital Coronary Artery Anomalies in Patients Undergoing Coronary Angiography at a Tertiary Care Hospital in the United Arab Emirates: A Retrospective Analysis

## TL;DR

This study found that congenital coronary artery anomalies are rare but clinically important in patients in Dubai, with myocardial bridging being the most common type.

## Contribution

The study provides new data on the prevalence and patterns of coronary artery anomalies in a UAE population.

## Key findings

- 1.48% of patients undergoing coronary angiography had congenital coronary artery anomalies.
- Myocardial bridging was the most common anomaly (52.2%), followed by anomalies of coronary origin (45.7%).
- Acute myocardial infarction was the most common clinical presentation (63.0%).

## Abstract

Background

Coronary artery anomalies (CAAs) are uncommon congenital variations with potentially significant clinical implications, including myocardial ischemia and sudden cardiac death. Data on their prevalence and patterns in the United Arab Emirates (UAE), particularly in Dubai, remain limited.

Objectives

This study aimed to evaluate the prevalence, anatomical types, and clinical presentation of CAAs among patients undergoing coronary angiography at a tertiary care center in Dubai.

Methods

A retrospective analysis was conducted on all coronary angiograms performed at Rashid Hospital between January 1, 2017, and December 31, 2023. Two independent cardiologists reviewed the angiograms to identify CAAs. Clinical data, including presentation and left ventricular ejection fraction (LVEF), were extracted from electronic medical records.

Results

Among 6,228 coronary angiograms, 92 patients (1.48%) were found to have CAAs. Myocardial bridging was the most frequent anomaly (52.2%), followed by anomalies of coronary origin (45.7%) and coronary artery fistula (2.2%). The majority of patients were men (85.9%), with a mean age of 54.0 ± 11.5 years. Acute myocardial infarction (AMI) was the most common presentation (63.0%). Most patients had preserved left ventricular ejection fraction (67%) and were discharged alive (97.8%). AMI occurred more frequently in origin-related CAAs (73.8%), while anginal symptoms were more common in course-related CAAs (37.5% versus 14.3%, P = 0.086).

Conclusion

CAAs were infrequent but clinically relevant findings in patients undergoing coronary angiography in Dubai. Myocardial bridging was the predominant anomaly. These results underscore the importance of systematic evaluation for CAAs during angiographic assessment. Further multicenter research utilizing advanced imaging and long-term follow-up is needed to refine risk stratification and management strategies.