Background: Although not well established; gender may play a role in the incidence, clinical
manifestations, and atherosclerotic burden of Coronary Artery Anomalies (CAAS). Our aim is to
investigate the impact of gender on coronary artery anomalies.
Methods: All coronary angiograms performed at the University Heart Center Zurich, Switzerland, between
January 2000 and December 2016 were investigated. Those of anomalous origin, course and
termination (fistula) were included in the analysis with the exclusion of coronary artery aneurysms and
Results: Out of the original 39577 angiographic studies that included 28550 males and 11026 females,
Coronary Artery Anomalies (CAAS) were documented in 130 (0.32%) patients of whom 69.2%
(n=90) and 30.8%(n=40) were males and females respectively. However, the overall prevalence of
coronary anomalies amongst both genders did not differ (0.32% vs 0.36%, P = 1) and so were the
basic characteristics except for hypertension, which was more prevalent in females (P = 0.03644). The
most prevalent anomaly overall was (left circumflex artery from right coronary artery/sinus), which
was present in (n=47, 36.2%). No impact of gender on the incidence of individual anomalies except
for Right Coronary Artery (RCA) originating from Left Circumflex Artery (LCX), which was only
documented in men (P = 0.0000116). On the other hand malignant CAAS presented equally with a
proportion of 10% for both genders (P = 1). Although males outnumbered females in terms of atherosclerotic
burden in CAAS this was statistically not significant (P = 0.331).
Conclusion: Both genders have a similar impact on the overall prevalence, clinical manifestations and
atherosclerotic burden of CAAs. Anomaly of RCA originating from LCX occurred more frequently in
males than females.