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[Indications for coronary angiography in patients with acquired heart valve diseases with reference to risk factors]
Insights
Coronary artery disease (CAD) affects 9% of patients with acquired valvular heart disease, particularly those over 50. Typical chest pain is a strong indicator of CAD in these patients.
Area of Science:
- Cardiology
- Cardiovascular Diseases
- Valvular Heart Disease
Background:
- Acquired valvular heart disease is common and can be associated with coronary artery disease (CAD).
- Identifying non-invasive markers for CAD in valvular heart disease patients is crucial for risk stratification.
Purpose of the Study:
- To determine the frequency of CAD in patients with acquired valvular heart disease.
- To identify clinical and biochemical parameters that predict significant coronary artery stenosis without invasive procedures.
Main Methods:
- Retrospective analysis of 266 consecutive patients with acquired valvular heart disease (aortic, mitral, or combined lesions).
- Evaluation of patient demographics, clinical presentation (chest pain), lipid profiles, and presence of significant coronary artery stenosis (≥50% diameter reduction).
Main Results:
- 9% of patients (24/266) had significant CAD.
- CAD prevalence increased with age (13% in patients >50 years vs. 1% <50 years), higher in men (19%) than women (7%).
- Typical chest pain was associated with CAD in 30% of cases, significantly higher than in patients without angina (5%) or with atypical chest pain (4%).
- Elevated cholesterol/triglycerides were more frequent in patients with CAD.
- 62% of patients with typical chest pain and mitral valve disease had CAD.
- No CAD was found in female patients without typical angina or in patients without typical angina and risk factors.
Conclusions:
- Coronary artery disease is prevalent in patients with acquired valvular heart disease, especially older individuals and men.
- Typical chest pain is a significant predictor of CAD in this population.
- Non-invasive assessment, including clinical symptoms and risk factors, can aid in identifying patients who may require further investigation for CAD.
Abstract:
The aims of the study were to examine the frequency of coronary artery disease (CAD) in patients with acquired valvular heart disease and to investigate the parameters by which significant coronary artery stenosis can be identified without invasive measures in these patients. For this reason 266 consecutive patients with acquired valvular heart disease (aortic, mitral or combined lesions) were examined retrospectively. In 24 patients (9%) a significant (50% or more reduction of the diameter) coronary artery stenosis was found. The prevalence of CAD increased with age: only one patient younger than 50 years, but 23 patients (13%) older than 50 years revealed significant CAD (19% men, 7% women). Increased levels of cholesterol and/or triglycerides were found more frequently in patients with CAD (33% and 29%, respectively) than in those without (6% and 12%, respectively). No differences were found in patients with aortic and mitral valve disease. Patients with typical chest pain revealed CAD in 30% of cases, whereas only 5% of the patients without angina pectoris (or 4% with atypical chest pain) showed a significant coronary artery stenosis. A high percentage (62%) of patients with typical chest pain and mitral valve disease revealed CAD. None of the 77 female patients without typical angina pectoris had significant coronary artery stenosis, whereas 11% of the male patients showed significant CAD even without typical symptoms. In 51 patients without typical angina pectoris and with no risk factors, no CAD was observed.(ABSTRACT TRUNCATED AT 250 WORDS)