title: Prevalence of coronary artery disease before valvular surgery in patients with rheumatic valvular disease.
abstract: BACKGROUND
  Although many patients with valvular heart disease have concomitant coronary artery disease (CAD), there are limited data on the association between rheumatic valvular disease (RVD) and CAD. In this study, we aimed to investigate the prevalence of CAD in a group of patients with RVD and undergoing coronary angiography before valvular surgery.
  
  
  METHODS
  In this retrospective analysis, we enrolled a total of 1075 patients (658 women, 61.2%; mean age: 53.2 ± 9.9 years) who underwent coronary angiography for the evaluation of CAD before valvular surgery between January 2003 and May 2010.
  
  
  RESULTS
  The overall prevalence of significant CAD was 11.1%. Patients with significant CAD were older than patients without significant CAD (55.16 ± 10.4 vs. 51.45 ± 9.1; P<0.001). In addition, hypertension, smoking, diabetes mellitus, and dyslipidemia were more prevalent among patients with significant CAD (P<0.05). After adjustment for several risk factors, only aortic stenosis remained the predictor of significant CAD (odds ratio: 1.66; 95% confidence interval: 1.26-2.19; P<0.001). However, aortic regurgitation was inversely associated with the presence of CAD (odds ratio: 0.56; 95% confidence interval: 0.21-1.01; P<0.001).
  
  
  CONCLUSIONS
  The overall prevalence of CAD in our population with RVD was low. Rheumatic aortic stenosis is associated with an increased prevalence of CAD, whereas the prevalence of CAD is lower in those patients with aortic regurgitation.
authors.affiliation: Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Enver
authors.initials: E
authors.lastname: Atalar
authors.forename: Hikmet
authors.initials: H
authors.lastname: Yorgun
authors.forename: Uğur
authors.initials: U
authors.lastname: Canpolat
authors.forename: Hamza
authors.initials: H
authors.lastname: Sunman
authors.forename: Alper
authors.initials: A
authors.lastname: Kepez
authors.forename: Uğur
authors.initials: U
authors.lastname: Kocabaş
authors.forename: Necla
authors.initials: N
authors.lastname: Ozer
authors.forename: Kenan
authors.initials: K
authors.lastname: Ovünç
authors.forename: Serdar
authors.initials: S
authors.lastname: Aksöyek
authors.forename: Ferhan
authors.initials: F
authors.lastname: Ozmen
mesh_terms: D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D004452:Echocardiography; D005260:Female; D006350:Heart Valve Prosthesis; D006351:Heart Valves; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012214:Rheumatic Heart Disease / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D014421:Turkey / Q000453:epidemiology