Title: Prevalence of Significant Coronary Artery Disease in Rheumatic Heart Disease Patients Undergoing Preoperative Coronary Angiography, Tanta University Hospital Experience
Authors: Mohamed Abdelaal* MD, Ayman Elsheikh MD, Kamal Eldin Ahmed MD, Wael Haseeb MD
DOI: https://dx.doi.org/10.18535/jmscr/v5i2.19
Abstract
Background: presence of significant coronary artery disease with rheumatic valvular heart disease patients requiring surgical valve intervention increases morbidity and mortality of such patients.
Aim of the study: to study the prevalence of significant coronary artery disease in patients undergoing preoperative coronary angiography in cardiology department, Tanta university hospital.
Patients and Methods: during the period from January 2015 to May 2016 all patients referred to our department to perform diagnostic coronary angiography before doing cardiac surgery for valvular rheumatic heart disease were included in the study. 96 patients were included. 51 patients were males and 45 patients were females.
We did echocardiography and coronary angiography (CAG) for all of them.
Results: of these 96 patients; 27 patients had severe aortic regurgitation, 23 patients had severe mitral regurgitation, 17 patients had severe aortic stenosis, 16 patients had combined lesions and 13 patients had severe mitral stenosis.
10 male patients and 6 female patients showed significant coronary artery disease in coronary angiography.
8 patients showed single vessel disease, 5 patients showed two vessel disease, and 3 patients showed 3 vessel disease.
Conclusion: our study showed that the prevalence of coronary artery disease in patients undergoing preoperative diagnostic coronary angiography was 16.66%. Such patients should be treated correctly to decrease their morbidity and mortality.
References
1. Eisenberg M.J.Rheumatic heart disease in the developing world: prevalence, prevention, and control Eur Heart J (1993) 14 (1): 122-128.
2. Shipton B., Wahba H. Valvular Heart Disease: Review and UpdateAm Fam Physician. 2001 Jun 1;63(11):2201-2209.
3. Manjunath C.N.,Agarwal A, Bhat P., Ravindranath K.S., Ananthakrishna R.,Rav-indran R., Agarwal N. Coronary artery disease in patients undergoing-ardiac surgery for non-coronary lesions in a tertiary care centre. Indian heart journal. 2014;66:52-56.
4. Czer LS, Gray RJ, De Robertis MA, Bateman TM, Stewart ME, Chaux A, et al. Mitral valve replacement: impact of coronaryartery disease and determinants of prognosis after evascularization. Circulation.1984;70:I198-I207
5. Nishimura RA, Otto CM, Bonow RO,Carabello BA, Erwin JP, Guyton RA et al. 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129:2440-2492.
6. Bozbaş H, Yildirir A, Küçük MA, Ozgül A, Atar I, Sezgin A, et al: Prevalence of coronary arterydisease in patients undergo-ing valvular operation due to rheumatic
involvement. Anadolu Kardiyol Derg 2004, 4:223–226.
7. Emren ZY, Emren SV, Kılıçaslan B, Solmaz H, Susam I, Sayın A, et al. Evaluation ofthe prevalence of coronary arterydisease in patients with valvular heart disease. Journal of Cardiothoracic Surgery 2014, 9:153
8. Sonmez K, Gencbay M, Akcay A,Yilmaz A, Pala S, Onat O, et al. Prevalence andpredictors of significantcoronary artery disease in Turkishpatients who undergo heart valve surgery. J HeartValve Dis.2002;11:431-437
9. Schaefer A, Jehle J, Loogen F. Indications for coronaryangiography in patients with acquired heart valve diseaseswith reference to risk factors.Z Kardiol. 1987;76:276-283.
10. Baxter RH, Reid JM, McGuiness JB, Stevenson JG.Relation ofangina to coronary artery disease in mitral and in aortic valvedisease. Br Heart J. 1978;40:918-922.
11. Jose VJ, Gupta SN, Joseph G, Chandy ST, George OK, Pati PK, et al. Prevalence of coronaryartery disease in patients with rheumatic heart disease inthe current era. Indian Heart J. 2004;56:129-131.
12. Kruczan DD, Silva NA, Pereira Bde B, Roma ˜o VA, CorreaFilho WB, Morales FE. Coronary artery disease in patientswith rheumatic and non-rheumatic valvular heart diseasetreated at a public hospital in Rio de Janeiro. Arq Bras Cardiol.2008;90:197-203.
13. Almahmeed W, Arnaout MS, Chettaoui R, Ibrahim M, Kurdi MI, Taher MA, et al coronary artery disease in Africa and the middle east.TherClin Risk Manag.2012; 8: 65–72.
14. Marchant E, Pichard A, Casanegra P. Report: Association of coronaryartery disease and valvular heart disease in Chile. ClinCardiol.1983;6:352-356.