Assessment of a predictive index for coronary artery disease in patients with rheumatic valvular disease.
OBJECTIVE
The authors studied the sensitivity and specificity, as well the positive and negative predictive values, of a prognostic index conformed by diastolic blood pressure, total number of cigarettes smoked during the lifetime, severity of angina pectoris, positive family history of ischemic heart diseases, age (years), current cigarette smoking, and total to HDL-cholesterol ratio in order to anticipate the presence of significant coronary artery disease in patients with rheumatic cardiac valvulopathy.


METHODS
A prospective, observational, non-randomized, cross-sectional and comparative study was performed in men and women > or = 30 and < or = 78 years of age, with rheumatic valve cardiopathy and who were submitted to catheterization and coronary angiography.


RESULTS
We studied 102 patients (61 women and 41 men) 55.63 +/- 9.88 years of age, range: 30-78 years (women 56.09 +/- 11.48, and men 54.6 +/- 11.35 years of age, respectively). The patients had mitral valve disease 30 (29.41%), 49 (48.03%) had mitral valve disease associated with aortic valve disease and 23 (22.55%) had aortic valvular disease. Significant coronary artery atherosclerosis was present in eight patients (7.84%). Sensitivity and specificity analysis resulted as follows: sensitivity, 50% and specificity, 80.85%. Positive predictive value was 0.18 and negative predictive value 0.95.


CONCLUSIONS
The index analyzed here is useful to predict cases without significant coronary artery disease in patients with rheumatic heart valvulopathy, but this index is not useful to identify significant coronary artery disease in such patients.
Salas-Lara
Victor Manuel
VM
Servicio de Hemodinámica, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico.
Rangel-Abundis
Alberto
A
Solorio-Meza
Sergio
S
Albarrán-López
Héctor
H
D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis*; D003627:Data Interpretation, Statistical; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012214:Rheumatic Heart Disease / Q000150:complications*; D012307:Risk Factors; D012680:Sensitivity and Specificity