Association of coronary artery disease and valvular heart disease in Chile
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This study found a lower prevalence of coronary artery disease (CAD) in Chilean patients with valvular heart disease (VHD) compared to previous reports. Angina symptoms were not always indicative of CAD, and CAD was often present without angina.
Area of Science:
- Cardiology
- Epidemiology
Background:
- Rheumatic valvular heart disease (VHD) is a significant cardiovascular condition.
- The co-occurrence of coronary artery disease (CAD) with VHD requires further investigation, particularly in diverse geographical settings.
Purpose of the Study:
- To determine the prevalence of significant coronary artery disease (CAD) in Chilean patients diagnosed with valvular heart disease (VHD).
- To analyze the relationship between specific types of VHD (mitral, aortic, combined) and the presence of CAD.
- To evaluate the correlation between angina symptoms, ECG findings, and confirmed CAD in this patient cohort.
Main Methods:
- A cohort of 100 patients with VHD referred for cardiac catheterization, aged over 50, and exhibiting angina or ischemic ECG signs were analyzed.
- Coronary angiography was the primary diagnostic tool to assess the degree of coronary artery obstruction.
- Statistical analysis was performed to correlate VHD type, angina, and CAD presence.
Main Results:
- Overall, 14% of patients exhibited significant CAD (>50% obstruction).
- Prevalence varied by VHD type: 7% in mitral valve disease (MVD), 18% in aortic valve disease (AVD), and 21% in combined mitral and aortic valve disease (MAVD).
- Angina prevalence differed significantly: 14% (MVD), 63% (AVD), 53% (MAVD). Only 57% of CAD patients had angina; 20% of angina patients had CAD. Hemodynamic parameters and ejection fraction showed no correlation with CAD.
Conclusions:
- The incidence of CAD in Chilean patients with VHD appears lower than reported in English literature.
- Angina pectoris is an unreliable indicator for CAD in VHD patients, as it is often absent when CAD is present and vice versa.
- Further research is warranted to understand the specific factors influencing CAD prevalence in VHD patients in different populations.
Abstract:
This study analyzes the prevalence of coronary artery disease (CAD) among patients with rheumatic valvular heart disease (VHD) in Chile. Coronary angiography was performed in all patients referred to cardiac catheterization with VHD who were over age 50 years and who had angina or ECG signs of ischemia. A total of 100 patients entered the study. Significant CAD (greater than 50% obstruction) was found in 14% of the cases: 7% in patients with mitral valve disease (MVD), 18% in aortic valve disease (AVD), and 21% in combined mitral and aortic valve disease (MAVD). Angina was present in 14% of the patients with MVD, 63% with AVD, and 53% with MAVD. Only 57% of patients with CAD had angina pectoris; 20% with angina had CAD. Hemodynamic parameters and left ventricular ejection fraction were not correlated with the presence or absence of CAD. We conclude that in patients with valvular heart disease, the incidence of CAD is lower in Chile than previously reported in the English literature. We confirmed the fact that angina is often not associated with CAD, and that CAD is often present in the absence of angina.