Aortic stenosis, angina pectoris, coronary artery disease

Area of Science:

• Cardiology
• Cardiac Surgery
• Vascular Medicine

Background:

• Aortic stenosis (AS) is a common valvular heart disease.
• Angina pectoris (AP) is a frequent symptom in AS patients.
• The relationship between AP and coronary artery disease (CAD) in AS requires further elucidation.

Purpose of the Study:

• To investigate the association between angina pectoris (AP) and coronary artery disease (CAD) in patients with aortic stenosis (AS).
• To evaluate the predictive value of AP for coexisting CAD in AS.
• To assess the impact of combined surgical interventions on operative mortality.

Main Methods:

• Retrospective review of 88 patients with AS.
• Analysis of coronary arteriograms to identify significant CAD (lesions >= 50%).
• Assessment of aortic valve gradient and correlation with AP and CAD incidence.

Main Results:

• 68% of AS patients experienced AP; 47% had coexisting CAD.
• AP presence did not significantly predict CAD.
• CAD was more likely in AS patients >= 60 years.
• AP was less likely with severe AS (gradient > 100 mmHg), suggesting AS as the cause.
• Combined aortic valve replacement and revascularization showed lower operative mortality than AS surgery alone.

Conclusions:

• Angina pectoris is common in AS but does not reliably indicate underlying CAD.
• Coronary arteriography is advised for AS patients aged 40 and older.
• Combined surgical treatment for AS and CAD may improve outcomes.