Coronary artery calcification (CAC) is a recognized marker of atherosclerosis and cardiovascular risk. While age and sex are established risk factors, the influence of coronary bifurcation angles (left anterior descending artery – LAD, left main artery – LMA, left circumflex artery – LCx) on CAC remains unclear. This study aimed to investigate the relationship between these anatomical angles, demographic factors, and CAC presence/severity. This retrospective cross-sectional study included 164 patients over 18 years of age who underwent coronary computed tomography angiography (CCTA) between April 2024 and October 2024. Ethical approval was obtained, and data were anonymized. Patients with prior interventions, anatomical variations, or poor image quality were excluded. Computed tomography (CT) images were obtained using a 128-slice scanner. Bifurcation angles were measured on 3D reconstructions. CAC was evaluated using non-contrast CT and the Agatston scoring method. Statistical and ROC analyses were performed to assess associations between variables.
CAC was more common in older and male patients (p < 0.05). Bifurcation angles, including LAD–LCx, showed no significant association with the presence or severity of CAC (p > 0.05; AUC values < 0.60). No significant correlation was found between angles and calcium scores. Age and male sex were strongly associated with CAC, supporting known risk patterns. LAD was the most frequently calcified vessel. Although bifurcation angles did not show significant predictive value, geometric trends suggest a potential hemodynamic role in early atherosclerosis. Male sex and age are significant predictors of CAC. While bifurcation angles were not independently predictive, their anatomical influence warrants further investigation, particularly regarding LAD involvement.
