title: Coronary artery disease in patients undergoing cardiac surgery for non-coronary lesions in a tertiary care centre.
abstract: BACKGROUND
  The objective of the present study was to determine the prevalence of coronary artery disease (CAD) in patients undergoing surgery for various valvular as well as non-valvular cardiac pathologies.
  
  
  METHODS
  Patients with various valvular and non-valvular pathologies were selected. All patients with age ≥ 40 years and an indication for open heart surgery underwent pre-operative coronary angiogram and were included in the study.
  
  
  RESULTS
  The mean age was 51.5 ± 9.02 years. 178 (59.3%) patients were males and 122 (40.7%) patients were females. Out of 300 patients, 270 (90%) patients had valvular heart disease (VHD) and 30 (10%) patients had non-valvular heart disease. Rheumatic heart disease (RHD), mitral valve prolapse (MVP), degenerative aortic valve disease (DAVD) and bicuspid aortic valve (BAV) was present in 161 (53.7%), 17 (5.7%), 60 (20%) and 32 (10.7%) patients respectively. Overall, 26 (8.7%) patients were found to have significant CAD. CAD was significantly more common in patients with VHD as compared to patients with other etiologies (1 patient, 3.3%, p < 0.05). In the valvular group, DAVD patients had maximum prevalence of CAD (14 patients, 23.4%, p < 0.05). In the group with CAD, the presence of variables such as age >60 years, male sex, typical angina, HT, dyslipidemia and smoking were significantly greater as compared to those with normal coronaries.
  
  
  CONCLUSIONS
  The overall prevalence of CAD among patients undergoing non-coronary cardiac surgery is 8.7%. Coronary artery disease is relatively uncommon in patients with rheumatic VHD (4.9%), while its prevalence is highest in DAVD (23.4%).
authors.affiliation: Professor, Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India.
authors.forename: Cholenahally Nanjappa
authors.initials: CN
authors.lastname: Manjunath
authors.affiliation: Resident, Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India. Electronic address: medashish@rediffmail.com.
authors.forename: Ashish
authors.initials: A
authors.lastname: Agarwal
authors.affiliation: Professor, Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India.
authors.forename: Prabhavathi
authors.initials: P
authors.lastname: Bhat
authors.affiliation: Professor, Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India.
authors.forename: Khandenahally Shankarappa
authors.initials: KS
authors.lastname: Ravindranath
authors.affiliation: Assistant Professor, Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Ananthakrishna
authors.affiliation: Resident, Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India.
authors.forename: R
authors.initials: R
authors.lastname: Ravindran
authors.affiliation: Assistant Professor, Department of Emergency Medicine, Kempe Gowda Institute of Medical Sciences, Bangalore, India.
authors.forename: Neena
authors.initials: N
authors.lastname: Agarwal
mesh_terms: D000328:Adult; D017677:Age Distribution; D006348:Cardiac Surgical Procedures / Q000379:methods; D016009:Chi-Square Distribution; D015331:Cohort Studies; D015897:Comorbidity; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery*; D006801:Humans; D033162:Incidental Findings; D007194:India; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods; D015995:Prevalence; D012189:Retrospective Studies; D012214:Rheumatic Heart Disease / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery; D018570:Risk Assessment; D017678:Sex Distribution; D062606:Tertiary Care Centers; D016896:Treatment Outcome
keywords: Coronary artery disease; Preoperative coronary angiogram; Prevalence