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Coronary arterial disease in patients with severe isolated aortic stenosis
J C García-Rubira1, V López, J Cubero
1Coronary Unit, University Hospital Virgen Macarena, Sevilla, Spain.
Insights
Coronary arterial disease is common in severe aortic stenosis, even without chest pain. Angina absence does not rule out coronary disease, necessitating further evaluation.
Area of Science:
- Cardiology
- Vascular Medicine
- Diagnostic Imaging
Background:
- Severe isolated aortic stenosis is a significant cardiovascular condition.
- Coronary arterial disease (CAD) often coexists with aortic stenosis.
- The presence and impact of CAD in patients with aortic stenosis require careful assessment.
Purpose of the Study:
- To determine the prevalence of coronary arterial disease in patients with severe isolated aortic stenosis.
- To evaluate the relationship between angina symptoms and the presence of CAD in this patient group.
- To inform clinical decision-making regarding coronary arteriography in severe aortic stenosis.
Main Methods:
- Retrospective review of 117 consecutive patients with severe isolated aortic stenosis.
- Analysis of coronary arterial disease prevalence based on symptom presentation (typical angina, atypical angina, no angina).
- Coronary arteriography data was used to confirm the presence of CAD.
Main Results:
- Coronary arterial disease was identified in 18 of 48 patients (37.5%) with typical angina.
- CAD was present in 10 of 38 patients (26.3%) with atypical angina.
- Importantly, 4 of 31 patients (12.9%) without any angina also had significant coronary arterial disease.
Conclusions:
- Absence of angina symptoms is not a reliable indicator to exclude coronary arterial disease in patients with severe isolated aortic stenosis.
- Coronary arteriography should be considered in the evaluation of severe aortic stenosis, irrespective of chest pain.
- This finding has implications for risk stratification and treatment planning in patients with severe aortic stenosis.
Abstract:
We reviewed the prevalence of coronary arterial disease in a consecutive series of 117 patients with severe isolated aortic stenosis. Coronary arterial disease was present in 18 of 48 patients with typical angina, in 10 of 38 patients with atypical angina, and in 4 of 31 patients without angina. We suggest that absence of angina is not enough to omit coronary arteriography in the evaluation of severe aortic stenosis.