Annales de cardiologie et d'angeiologie · 2026
[Contribution of coronary computed tomography angiography in the screening of anomalous origins of coronary arteries: A retrospective study of 422 examinations in a West African Country].
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Angoran Regnier I, N'Cho-Mottoh M P, Ekou A, Garba I, Coulibaly A, N'Guetta A R
Аннотация
INTRODUCTION: Anomalous origins of coronary arteries (AOCA) represent the second leading cause of sudden cardiac death in young individuals. Diagnosis is challenging because symptoms often mimic classic ischemia or present as MINOCA (Myocardial Infarction with Non-Obstructive Coronary Arteries). This study aimed to evaluate the prevalence and malignancy criteria of AOCA in patients undergoing coronary angiography in Abidjan.
MATERIALS AND METHODS: A retrospective study was conducted in Abidjan, Côte d'Ivoire, analyzing 422 coronary CT angiograms performed between May 2023 and December 2025. The protocol included calcium scoring and angiographic acquisition to analyze the arterial course and wall. Post-processing was performed on a dedicated workstation. Investigated malignancy criteria included ectopic origin, inter-arterial course, acute ostial angulation, intramural course, and the presence of a slit-like ostium.
RESULTS: The prevalence of AOCA was 1.65% (7 cases). The mean age was 51.4±12 years. Chest pain was the primary reason for consultation (85.71% of cases). Calcium scores were zero in 85.71% of patients. The most frequent anomaly was the right coronary artery arising from the left sinus (n=3; 42.85%). There were also two (2) cases (28.57%) of ectopic right coronary origin from the aorta and two (2) cases of ectopic origin of the left anterior descending artery. A high-risk inter-arterial course was identified in 85.71% of patients.
CONCLUSION: Coronary CT angiography is essential for the anatomical characterization and risk stratification of AOCA. In the African context, the increasing accessibility of coronary CT scanning provides a major opportunity for early detection and primary prevention of sudden cardiac death.
MATERIALS AND METHODS: A retrospective study was conducted in Abidjan, Côte d'Ivoire, analyzing 422 coronary CT angiograms performed between May 2023 and December 2025. The protocol included calcium scoring and angiographic acquisition to analyze the arterial course and wall. Post-processing was performed on a dedicated workstation. Investigated malignancy criteria included ectopic origin, inter-arterial course, acute ostial angulation, intramural course, and the presence of a slit-like ostium.
RESULTS: The prevalence of AOCA was 1.65% (7 cases). The mean age was 51.4±12 years. Chest pain was the primary reason for consultation (85.71% of cases). Calcium scores were zero in 85.71% of patients. The most frequent anomaly was the right coronary artery arising from the left sinus (n=3; 42.85%). There were also two (2) cases (28.57%) of ectopic right coronary origin from the aorta and two (2) cases of ectopic origin of the left anterior descending artery. A high-risk inter-arterial course was identified in 85.71% of patients.
CONCLUSION: Coronary CT angiography is essential for the anatomical characterization and risk stratification of AOCA. In the African context, the increasing accessibility of coronary CT scanning provides a major opportunity for early detection and primary prevention of sudden cardiac death.