Prevalence of Coronary Artery Disease in Patients Undergoing Valvular Heart Surgery
DOI:
https://doi.org/10.1532/hsf.5331Keywords:
coronary artery disease, valvular heart disease, prevalence, coronary artery bypass graftingAbstract
Background: The risk of coronary artery disease (CAD) in different valve dysfunction has been unclear.
Methods: We reviewed patients, who underwent valve heart surgery and coronary angiography from 2008 to 2021, at our center.
Results: A total of 7,932 patients were included in the present study, and 1,332 (16.8%) had CAD. The mean age of the study cohort was 60.5±7.9 years, and 4,206 (53.0%) were male. CAD was 21.4% in aortic disease, 16.2% in mitral valve disease, 11.8% in isolated tricuspid valve disease, and 13.0% in combined aortic and mitral valve disease. Patients with aortic stenosis were older than those with regurgitation (63.6±7.4 years vs. 59.5±8.2 years, P < 0.001), and the CAD risks also were higher (28.0% vs. 19.2%, P < 0.001). The age difference was minimal (60.6±8.2 years vs. 59.5±6.7 years, P = 0.002) between patients with mitral valve regurgitation and stenosis, but the risks of CAD were twice high in regurgitation (20.2% vs. 10.5%, P < 0.001). When the type of valve impairment was not considered, non-rheumatic etiology, advanced age, male sex, hypertension, and diabetes were independent predictors of CAD.
Conclusion: In patients undergoing valve surgery, the prevalence of CAD was influenced by conventional risk factors. Importantly, CAD also was associated with the type and etiology of valve diseases.
References
Atalar E, Yorgun H, Canpolat U, Sunman H, Kepez A, Kocabaş U, Ozer N, Ovünç K, Aksöyek S, Ozmen F. 2012. Prevalence of coronary artery disease before valvular surgery in patients with rheumatic valvular disease. Coronary Artery Disease. 23(8), 533–537.
Bruno VD, Zakkar M, Guida G, Rapetto F, Rathore A, Ascione R. 2020. Combined Degenerative Mitral Valve and Coronary Surgery: Early Outcomes and 10-Year Survival. The Annals of Thoracic Surgery. 110(5), 1527–1533.
Cazelli JG, Camargo GC, Kruczan DD, Weksler C, Felipe AR, Gottlieb I. 2017. Prevalence and Prediction of Obstructive Coronary Artery Disease in Patients Undergoing Primary Heart Valve Surgery. Arquivos brasileiros de cardiologia. 109(4), 348–356.
Emren ZY, Emren SV, Kılıçaslan B, Solmaz H, Susam İ, Sayın A, Abud B, Aydın M, Bayturan Ö. 2014. Evaluation of the prevalence of coronary artery disease in patients with valvular heart disease. Journal of Cardiothoracic Surgery. 9, 153.
Hasselbalch RB, Engstrøm T, Pries-Heje M, Heitmann M, Pedersen F, Schou M, Mickley H, Elming H, Steffensen R, Køber L, Iversen K. 2017. Coronary risk stratification of patients undergoing surgery for valvular heart disease. International Journal of Cardiology. 227, 37–42.
Konst RE, Guzik TJ, Kaski JC, Maas AHEM, Elias-Smale SE. 2020. The pathogenic role of coronary microvascular dysfunction in the setting of other cardiac or systemic conditions. Cardiovascular Research. 116(4), 817–828.
Kruczan DD, Silva NA de Se, Pereira B de B, Romão VA, Correa Filho WB, Morales FEC. 2008. Coronary artery disease in patients with rheumatic and non-rheumatic valvular heart disease treated at a public hospital in Rio de Janeiro. Arquivos Brasileiros de Cardiologia. 90(3), 197–203.
Manjunath CN, Agarwal A, Bhat P, Ravindranath KS, Ananthakrishna R, Ravindran R, Agarwal N. 2014. Coronary artery disease in patients undergoing cardiac surgery for non-coronary lesions in a tertiary care centre. Indian Heart Journal. 66(1), 52–56.
Matta A, Moussallem N. 2019. Coronary artery disease is associated with valvular heart disease, but could it Be a predictive factor? Indian Heart Journal. 71(3), 284–287.
Narang R, Chadha DS, Goel K, Mishra S, Bajaj N, Sharma S, Gupta N, Bahl VK. 2009. Screening coronary angiography prior to surgery in rheumatic valvular heart disease: a study of 2,188 patients. The Journal of Heart Valve Disease. 18(4), 455–460.
Sonmez K, Gencbay M, Akcay A, Yilmaz A, Pala S, Onat O, Duran NE, Degertekin M, Turan F. 2002. Prevalence and predictors of significant coronary artery disease in Turkish patients who undergo heart valve surgery. The Journal of Heart Valve Disease. 11(3), 431–437.
Thalji NM, Suri RM, Daly RC, Dearani JA, Burkhart HM, Park SJ, Greason KL, Joyce LD, Stulak JM, Huebner M, Li Z, Frye RL, Schaff HV. 2013. Assessment of coronary artery disease risk in 5463 patients undergoing cardiac surgery: when is preoperative coronary angiography necessary? The Journal of Thoracic and Cardiovascular Surgery. 146(5), 1055–1063, 1064.e1; discussion 1063-1064.
Writing Committee Members, Lawton JS, Tamis-Holland JE, Bangalore S, Bates ER, Beckie TM, Bischoff JM, Bittl JA, Cohen MG, DiMaio JM, Don CW, Fremes SE, Gaudino MF, Goldberger ZD, Grant MC, Jaswal JB, Kurlansky PA, Mehran R, Metkus TS Jr., Zwischenberger BA. 2022. 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Journal of the American College of Cardiology. 79(2), e21–e129.
Xu Z, Pan J, Chen T, Zhou Q, Wang Q, Cao H, Fan F, Luo X, Ge M, Wang D. 2018. A prediction score for significant coronary artery disease in Chinese patients ≥50 years old referred for rheumatic valvular heart disease surgery. Interactive Cardiovascular and Thoracic Surgery. 26(4), 623–630.
