title: Prevalence of coronary artery disease in patients undergoing valvular operation due to rheumatic involvement.
abstract: OBJECTIVE
  Rheumatic heart disease is still a major health problem in developing countries. The impact of coronary artery disease (CAD) on or its relation to rheumatic fever is not well established. We aimed to evaluate the prevalence of CAD and atherosclerotic risk factors in patients who underwent valvular surgery due to rheumatic heart disease.
  
  
  METHODS
  The records of 346 patients who had undergone rheumatic valvular surgery in a university hospital between 1996 and 2002 were evaluated.
  
  
  RESULTS
  Coronary angiography was performed in 218 (63%) patients, of whom 41 (18.8%) had CAD. The mean age of the patients having CAD and normal coronary arteries were 57.3 and 50.5 years respectively (p<0.001). In the study population patients with CAD had significantly increased prevalence of diabetes mellitus (14.6% vs. 4.5%; p=0.02), hypertension (36.6% vs. 16.4%; p=0.003), smoking (51.2% vs. 23.2%; p=0.001) and family history of CAD (39.5% vs. 20.0%; p=0.01) compared to patients with normal coronary arteries. However, the prevalence of dyslipidemia was similar in both groups (45.9% vs. 36.4%; p=0.1).
  
  
  CONCLUSIONS
  These findings suggest that coronary artery disease prevalence in rheumatic valvular disease patients is similar to the normal population of same age. In cases where invasive assessment of valvular lesions is not indicated we suggest coronary angiography to be performed only in patients having clinical suspicion of CAD or multiple risk factors.
authors.affiliation: Department of Cardiology, School of Medicine, Başkent University, Ankara, Turkey. mdhbozbas@yahoo.com
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Bozbaş
authors.forename: Aylin
authors.initials: A
authors.lastname: Yildirir
authors.forename: Mehmet Alparslan
authors.initials: MA
authors.lastname: Küçük
authors.forename: Aliseydi
authors.initials: A
authors.lastname: Ozgül
authors.forename: Ilyas
authors.initials: I
authors.lastname: Atar
authors.forename: Atilla
authors.initials: A
authors.lastname: Sezgin
authors.forename: Sait
authors.initials: S
authors.lastname: Aşlamaci
authors.forename: Mehmet Emin
authors.initials: ME
authors.lastname: Korkmaz
authors.forename: Bülent
authors.initials: B
authors.lastname: Ozin
authors.forename: Haldun
authors.initials: H
authors.lastname: Müderrisoğlu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D003920:Diabetes Mellitus; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D006973:Hypertension; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012214:Rheumatic Heart Disease / Q000150:complications / Q000601:surgery*; D012307:Risk Factors; D012907:Smoking; D014421:Turkey / Q000453:epidemiology