Prevalence of coronary artery disease in patients with rheumatic heart disease in the current era.
BACKGROUND
This study was undertaken to determine the prevalence of coronary artery disease in patients with rheumatic heart disease undergoing valve surgery.


RESULTS
Consecutive patients with rheumatic heart disease (n=376) who were above the age of 40 years, and scheduled for valve surgery underwent diagnostic coronary angiogram to delineate coronary arteries. The patients were divided into three groups based on valve involvement (mitral valve, aortic valve, and combined aortic and mitral valve). Significant coronary artery disease was considered to be present if one or more coronaries showed 50% or more luminal stenosis. There were 287 (76.3%) males and 89 (23.7%) females. The mean age of the study population was 51.2+/-8.2 years. Eighty-nine (23.8%) patients had typical chest pain, 116 (30.6%) patients had atypical chest pain and 171 (45.5%) patients had no chest pain. Hypertension was noted in 88 (23.4%) patients, 65 (17.3%) patients had diabetes, 98 (26.1%) patients were smoker, and 66 (17.6%) patients had dyslipidemia, and 15 (4.0%) patients gave past history of myocardial infarction. Of the total 376 patients, 46 (12.2%) patients were found to have significant coronary artery disease. In patients with mitral vale disease the prevalence was 13.5% (13/96), while it was 15.3% (19/124) in patients with aortic valve disease and 9% (14/156) in those with combined mitral and aortic valve disease.


CONCLUSIONS
Our results suggest that the overall prevalence of coronary artery disease in a group of patients with rheumatic heart disease undergoing valve surgery in the current era is 12.2%. This prevalence is much lower than the figures reported earlier in the Western literature.
Jose
V Jacob
VJ
Department of Cardiology, Christian Medical College, Vellore. cardio2@cmcvellore.ac.in
Gupta
Satya N
SN
Joseph
George
G
Chandy
Sunil Thomas
ST
George
Oommen K
OK
Pati
Purendra Kumar
PK
John
Bobby
B
George
Paul
P
D000328:Adult; D017677:Age Distribution; D016009:Chi-Square Distribution; D015331:Cohort Studies; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D006350:Heart Valve Prosthesis; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011336:Probability; D011379:Prognosis; D012214:Rheumatic Heart Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D015996:Survival Rate; D016896:Treatment Outcome