Prevalence of coronary artery disease in patients undergoing valvular operation due to rheumatic involvement.
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.
Bozbaş
Hüseyin
H
Department of Cardiology, School of Medicine, Başkent University, Ankara, Turkey. mdhbozbas@yahoo.com
Yildirir
Aylin
A
Küçük
Mehmet Alparslan
MA
Ozgül
Aliseydi
A
Atar
Ilyas
I
Sezgin
Atilla
A
Aşlamaci
Sait
S
Korkmaz
Mehmet Emin
ME
Ozin
Bülent
B
Müderrisoğlu
Haldun
H
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