title: Impact of coronary artery disease on in-hospital mortality in patients with aortic valve disease. Results from the German ALKK registry.
abstract: OBJECTIVE
  Although aortic valve disease (AVD) is frequently associated with coronary artery disease (CAD), little is known about the impact of significant coronary artery disease on mortality after diagnostic cardiac catheterization in patients with AVD.
  
  
  METHODS
  We analyzed data of the coronary angiography registry of the "Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte" (ALKK) in Germany. The primary endpoint was in-hospital mortality.
  
  
  RESULTS
  A total of 1427 consecutive patients with AVD (438 patients with CAD versus 989 patients without CAD) underwent diagnostic catheterization in 2006 in 42 hospitals. All cause in-hospital mortality was more than threefold higher in patients with CAD (16/438; 3.7%) as compared to patients without CAD (12/989; 1.2%; p < 0.01; OR 3.09, 95% CI 1.45-6.58). Even after adjustment for age, sex, presence of diabetes mellitus and renal insufficiency, in-hospital all cause mortality remained statistically significant different between the two groups (OR 2.4; 95% CI 1.09-5.28; p < 0.01). Several factors, such as transient ischemic attack/stroke, volume of contrast agent, and left heart catheter-associated complications could not be identified as possible causes for the increase in mortality.
  
  
  CONCLUSIONS
  This analysis in patients with the leading diagnosis of AVD shows a significantly higher in-hospital mortality after diagnostic cardiac catheterization in case of an accompanying CAD. However, further studies are necessary to identify the driving force for the increase in mortality.
authors: Department of Internal Medicine/Cardiology, University of Leipzig - Heart Center, Struempellstrasse 39, Leipzig, Germany. Robert.Hoellriegel@med.uni-leipzig.de
authors: R
authors: R
authors: Höllriegel
authors: A
authors: A
authors: Linke
authors: M
authors: M
authors: Hochadel
authors: G
authors: G
authors: Schuler
authors: S
authors: S
authors: Kerber
authors: R
authors: R
authors: Hambrecht
authors: E
authors: E
authors: Grube
authors: K E
authors: KE
authors: Hauptmann
authors: R
authors: R
authors: Zahn
authors: U
authors: U
authors: Zeymer
authors: J
authors: J
authors: Senges
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000000981:diagnostic imaging; D000082882:Bicuspid Aortic Valve Disease; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000401:mortality*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000401:mortality*; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging* / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D008297:Male; D011859:Radiography; D012042:Registries; D012307:Risk Factors; D015996:Survival Rate