Coronary angiography, despite current shortcomings, has been regarded as golden standard for the assessment of coronary arteries. Geodesic pattern of coronary arteries characterized by curvature, torsion and tortuosity parameters can also be determined through angiography. Apart from atherosclerosis; age, hypertension, left ventricular hypertrophy and coronary flow are some of the determinants for the geodesic pattern of coronary arteries. Besides, a unique feature of coronary vasculature that differs from all other arterial sites is the repetitive flexion during each cardiac contraction. Thus, the geodesic pattern of coronary arteries may conceivably possess an adjunctive merit in estimating cardiovascular risk and have promising implications for discerning those who require meticulous follow-up. A more thorough understanding of the precise determinants for the coronary geodesic pattern would help establish its potential causal interaction with cardiovascular risk. (C) 2008 Elsevier Ireland Ltd. All rights reserved.