Prevalence of coronary artery disease before valvular surgery in patients with rheumatic valvular disease

• Published in: Coronary artery disease Vol. 23; no. 8; pp. 533 - 537
• Main Authors: Atalar, Enver, Yorgun, Hikmet, Canpolat, Uğur, Sunman, Hamza, Kepez, Alper, Kocabaş, Uğur, Özer, Necla, Övünç, Kenan, Aksöyek, Serdar, Özmen, Ferhan
• Format: Journal Article
• Language: English
• Published: England Lippincott Williams & Wilkins, Inc 01-12-2012
• Subjects: Coronary Angiography; Coronary Artery Disease - complications; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - epidemiology; Echocardiography; Female; Heart Valve Prosthesis; Heart Valves; Humans; Male; Middle Aged; Prevalence; Retrospective Studies; Rheumatic Heart Disease - complications; Rheumatic Heart Disease - diagnosis; Rheumatic Heart Disease - surgery; Turkey - epidemiology
• ISSN: 0954-6928; 1473-5830
• DOI: 10.1097/MCA.0b013e32835aab26

BACKGROUNDAlthough many patients with valvular heart disease have concomitant coronary artery disease (CAD), there are limited data on the association between rheumatic valvular disease (RVD) and CAD. In this study, we aimed to investigate the prevalence of CAD in a group of patients with RVD and undergoing coronary angiography before valvular surgery.
METHODSIn this retrospective analysis, we enrolled a total of 1075 patients (658 women, 61.2%; mean age53.2±9.9 years) who underwent coronary angiography for the evaluation of CAD before valvular surgery between January 2003 and May 2010.
RESULTSThe overall prevalence of significant CAD was 11.1%. Patients with significant CAD were older than patients without significant CAD (55.16±10.4 vs. 51.45±9.1; P<0.001). In addition, hypertension, smoking, diabetes mellitus, and dyslipidemia were more prevalent among patients with significant CAD (P<0.05). After adjustment for several risk factors, only aortic stenosis remained the predictor of significant CAD (odds ratio1.66; 95% confidence interval1.26–2.19; P<0.001). However, aortic regurgitation was inversely associated with the presence of CAD (odds ratio0.56; 95% confidence interval0.21–1.01; P<0.001).
CONCLUSIONThe overall prevalence of CAD in our population with RVD was low. Rheumatic aortic stenosis is associated with an increased prevalence of CAD, whereas the prevalence of CAD is lower in those patients with aortic regurgitation.