[Indications for coronarography in heart valve diseases]

Area of Science:

• Cardiology
• Vascular Medicine
• Rheumatology

Background:

• Rheumatic heart disease (RHD) is a significant global health concern.
• The co-occurrence of RHD and coronary atherosclerosis (CA) requires careful consideration for diagnostic procedures.
• Literature reports vary on the prevalence of CA in RHD patients.

Purpose of the Study:

• To determine the prevalence of coronary atherosclerosis in patients with rheumatic heart disease.
• To analyze the demographic and clinical characteristics of RHD patients with coexisting CA.
• To evaluate the utility of age as an indicator for recommending coronary angiography in RHD patients.

Main Methods:

• Retrospective analysis of 407 RHD patients.
• Assessment of coronary atherosclerosis prevalence and severity.
• Comparison of age distribution between RHD patients with and without CA.
• Analysis of affected coronary arteries and stenosis degree.

Main Results:

• 8.3% of RHD patients had coronary atherosclerosis; prevalence of mitral and aortic stenosis was lower than reported.
• The mean age of RHD patients with CA was approximately 59-60 years, with 50% diagnosed at or before 60.
• Anterior descending artery was most frequently affected; single-vessel disease was common, with mean stenosis of 75.2%.

Conclusions:

• Age is not a reliable sole indicator for recommending coronary angiography in RHD patients.
• Indiscriminate use of coronary angiography based on age may lead to unnecessary procedures and risks.
• Decision to perform coronary angiography should consider CA prevalence in RHD and individual atherosclerosis risk factors.