title: Predictors of coronary and carotid atherosclerosis in patients with severe degenerative aortic stenosis.
abstract: BACKGROUND
  Patients with degenerative aortic stenosis (AS) exhibit elevated prevalence of coronary artery disease (CAD) and internal carotid artery stenosis (ICAS). Our aim was to investigate prevalence of significant CAD and ICAS in relation to demographic and cardiovascular risk profile among patients with severe degenerative AS.
  
  
  METHODS
  We studied 145 consecutive patients (77 men and 68 women) aged 49-91 years (median, 76) with severe degenerative AS who underwent coronary angiography and carotid ultrasonography in our tertiary care center. The patients were divided into two groups according to the presence of either significant CAD (n=86) or ICAS (n=22).
  
  
  RESULTS
  The prevalence of significant CAD or ICAS was higher with increasing number of traditional risk factors (hypertension, hypercholesterolemia, diabetes, smoking habit) and decreasing renal function. We found interactions between age and gender in terms of CAD (p=0.01) and ICAS (p=0.06), which was confirmed by multivariate approach. With the reference to men with a below-median age, the prevalence of CAD or ICAS increased in men aged >76 years (89% vs. 55% and 28% vs. 14%, respectively), whereas the respective percentages were lower in older vs. younger women (48% vs. 54% and 7% vs. 17%).
  
  
  CONCLUSIONS
  In severe degenerative AS gender modulates the association of age with coronary and carotid atherosclerosis with its lower prevalence in women aged >76 years compared to their younger counterparts. This may result from a hypothetical "survival bias", i.e., an excessive risk of death in very elderly women with severe AS and coexisting relevant coronary or carotid atherosclerosis.
authors: 2nd Department of Cardiology, Faculty of Medicine, Jagiellonian University Medical College and University Hospital, Cracow, Poland. bobrowska.beata@gmail.com
authors: Beata
authors: B
authors: Bobrowska
authors: Wojciech
authors: W
authors: Zasada
authors: Andrzej
authors: A
authors: Surdacki
authors: Tomasz
authors: T
authors: Rakowski
authors: Paweł
authors: P
authors: Kleczyński
authors: Jolanta
authors: J
authors: Świerszcz
authors: Olga
authors: O
authors: Kruszelnicka
authors: Renata
authors: R
authors: Rajtar-Salwa
authors: Saleh
authors: S
authors: Arif
authors: Danuta
authors: D
authors: Sorysz
authors: Dariusz
authors: D
authors: Dudek
authors: Jacek S
authors: JS
authors: Dubiel
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000150:complications / Q000503:physiopathology*; D002340:Carotid Artery Diseases / Q000209:etiology / Q000503:physiopathology*; D003324:Coronary Artery Disease / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012737:Sex Factors
keywords: carotid atherosclerosis; coronary artery disease; degenerative aortic stenosis; elderly; gender.
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