Report: Association of coronary artery disease and valvular heart disease in chile

Abstract

Summary: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.

Prevalence of Coronary Artery Disease in Patients With Valvular Heart Disease

“…Combined valve lesion is insignificantly high among patients with coronary artery disease (p=0.154). The findings are supported by Morrison GW et al [2] , Chun et al [9] and Marchant E et al [1] Mean age of the patients with coronary artery disease (59.45±10.58) was significantly high in comparison to without coronary artery disease (48.92±6.57). This is supported by a retrospective study by Gupta KG et al [10] , where the mean age of the patients with significant coronary artery disease was 54.5±6.6 years as against a mean age of 49±7.5 years for those without coronary artery disease (p<0.01).…”

“…The overall prevalence of coronary artery disease with valvular heart disease in western world ranges from 14% to 29%. [1,2] The prevalence of coronary artery disease with rheumatic heart disease in English literature varies from 4% to 13%. [3,4] India has quoted to have 12.2% and 12% prevalence of coronary artery disease and rheumatic valvular heart disease respectively.…”

2008 Focused Update Incorporated Into the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease

“…The prevalence of CAD in patients with MS (an average of 20%) is lower than in patients with aortic valve disease, 1015,1017,1018,1021,1022 an observation explained principally on the basis of differences in age and gender. Nonetheless, because of the impact of untreated CAD on perioperative and long-term postoperative survival, preoperative identification of CAD is of great importance in patients with AR or MS and those with AS.…”

ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease

“…patients with aortic valve disease (1015,1017,1018,1021,1022), an observation explained principally on the basis of differences in age and gender. Nonetheless, because of the impact of untreated CAD on perioperative and long-term postoperative survival, preoperative identification of CAD is of great importance in patients with AR or MS and those with AS.…”