[Prevalence and prediction of significant coronary artery lesions in patients with valvular heart diseases requiring surgery].
OBJECTIVE
First to estimate the prevalence of significant coronary artery narrowings in patients suffering from valvular heart diseases requiring surgery and second to assess the parameters able to predict significant coronary stenoses in those patients.


METHODS
Retrospective study of a group consisting of 92 patients (29 female, 63 male, mean age 61 +/- 7.15 years) with coronary angiography carried out before surgical valve correction. Patients having ischemia-related mitral regurgitation were excluded from the study. Significant coronary artery stenosis was defined as a luminal narrowing of an epicardial artery of at least 50%. Anginal pain and cardiovascular risk factors were ascertained therewith.


RESULTS
Significant coronary artery stenoses were found in 24% of all patient enrolled in the study, their prevalence in the subgroup with aortic valve disease (alone or associated with mitral valve disease) and in the subgroup with isolated mitral valve disease being similar (31.8% vs. 21.4%, p = 0.2). The anginal chest pain, increased waist circumference and a host of at least 3 conventional cardiovascular risk factors were the elements best correlated with the presence of significant coronary narrowings.


CONCLUSIONS
Both Romanian patients and patients from industrialized countries afflicted with valvular heart diseases have similar prevalence of coronary heart disease. The prevalence tends to increase in patients with abdominal obesity and in those with many risk factors, diabetes mellitus being the most frequently encountered traditional risk factor. Renal function impairment might represent a predictive marker for coronary heart disease in valvular patients.
Universitatea de Medicină şi Farmacie Gr. T. Popa Iaşi, Facultatea de Medicină, Institutul de Boli Cardiovasculare G.I.M. Georgescu Iaşi.
Rodica
R
Radu
L
L
Lucaci
Cătălina
C
Arsenescu-Georgescu
D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000209:etiology; D001021:Aortic Valve / Q000473:pathology / Q000601:surgery*; D023921:Coronary Stenosis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery*; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000473:pathology / Q000601:surgery*; D011237:Predictive Value of Tests; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012383:Romania / Q000453:epidemiology; D016896:Treatment Outcome; D055105:Waist Circumference