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Angina, coronary risk factors and coronary artery disease in patients with valvular disease. A prospective study

D R Ramsdale, D H Bennett, C L Bray

    European Heart Journal
    |September 1, 1984
    PubMed

    Insights

    Coronary artery disease is common in patients with valvular heart disease. Preoperative coronary arteriography may be unnecessary for patients without angina or risk factors.

    Area of Science:

    • Cardiology
    • Cardiac Surgery

    Background:

    • Valvular heart disease (VHD) can coexist with coronary artery disease (CAD).
    • Assessing CAD risk in VHD patients is crucial for treatment planning.

    Purpose of the Study:

    • To investigate the relationship between coronary risk factors, angina, and significant CAD in patients with VHD undergoing coronary arteriography.

    Main Methods:

    • Prospective study of 387 consecutive patients with VHD undergoing coronary arteriography before valve replacement.
    • Analysis of the prevalence of CAD based on VHD type, presence of angina, and number of coronary risk factors.

    Main Results:

    • CAD prevalence was similar in mitral (31.9%) and aortic (26.8%) valve disease.
    • Significant CAD was found in 19.2% of patients without angina, indicating angina is an unreliable indicator.
    • CAD prevalence and severity increased with the number of coronary risk factors (P < 0.001).
    • Only 3% of patients with neither angina nor risk factors had significant CAD.

    Conclusions:

    • Angina is an unreliable predictor of significant CAD in VHD patients.
    • Coronary risk factors are strongly associated with CAD prevalence and severity in VHD.
    • Preoperative coronary arteriography may be safely omitted in VHD patients lacking both angina and coronary risk factors.

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