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Risk factors for degenerative aortic valve disease in India: A case control study
D S Chadha1, S K Malani2, P Bharadwaj3
1Senior Advisor (Medicine & Cardiology), Command Hospital (Air Force), Bangalore, India.
Insights
Cardiovascular risk factors like smoking and high LDL are linked to aortic stenosis in Asian Indians. These factors are independently associated with the condition, regardless of age or gender.
Area of Science:
- Cardiology
- Epidemiology
- Genetics
Background:
- Degenerative aortic valve disease frequently co-occurs with coronary artery disease (CAD).
- Western studies indicate shared risk factors between aortic valve disease and CAD.
- Limited data exists on these risk factors within the Asian Indian population.
Purpose of the Study:
- To investigate the prevalence of cardiovascular risk factors in Asian Indians with degenerative aortic valve disease.
- To identify specific risk factors associated with aortic stenosis in this demographic.
Main Methods:
- A cohort of 91 patients with severe aortic stenosis (AS) undergoing left heart catheterization was studied.
- Patients were compared to age- and sex-matched controls from a database of 3200 patients.
- Assessed risk factors included age, gender, family history of CAD, smoking, diabetes, hypertension, and dyslipidemia.
Main Results:
- Smoking, family history of CAD, and hypercholesterolemia were more common in AS patients.
- Diabetes mellitus showed no significant difference between groups.
- Multivariate analysis revealed independent associations between AS and family history of premature CAD, smoking, and elevated LDL levels.
Conclusions:
- Cardiovascular risk factors are significantly associated with aortic stenosis in Asian Indian patients.
- These associations are independent of age and gender.
- Findings highlight the importance of addressing these risk factors in preventing AS in this population.
Background:
Degenerative aortic valve disease often co-exists with coronary artery disease (CAD) and studies done in western populations have shown that it shares the same risk factors which cause CAD. However little is known in this context among Asian Indians. The current study looks into the risk factors of degenerative aortic valve disease in Asian Indian population.
Methods:
Ninety-one consecutive patients with severe aortic stenosis (AS) reporting for left heart catheterization prior to valve replacement surgery at a tertiary care centre were recruited for the study. They were compared with age and sex matched controls selected from a database of 3200 patients referred for elective diagnostic left heart catheterization for suspected CAD. Following traditional cardiovascular risk factors were assessed in all patients: age, gender, family history of CAD, smoking history, presence of diabetes, hypertension and dyslipidemia.
Results:
The mean age of the study population was 57.8 ± 8.2 years (range, 40-80 years). Smoking, family history of CAD and hypercholesterolemia were significantly more prevalent in patients with degenerative AS compared to those with normal valves. No significant difference was noted in the presence of diabetes mellitus. On multivariate logistic regression, family history of premature CAD (OR 3.68; CI 1.38-9.78) smoking history (OR, 2.56; CI, 1.21-5.39), and raised LDL levels (OR, 5.55; CI, 2.63-11.69) were independently associated with the aortic stenosis patient cohort.
Conclusions:
The study showed a significant association of cardiovascular risk factors with aortic stenosis independent of age and gender in Asian Indian patients.
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