Abstract

Introduction

Valvular heart diseases (VHD) are a significant problem in the Polish population. Coexistence of coronary artery disease (CAD) in patients with VHD increases the risk of death and affects the further therapeutic strategy.

Aim

Analysis of atherosclerotic plaque burden distribution in coronary arteries and long-term prognosis among patients with VHD.

Material and methods

Inclusion criteria were met by 1025 patients with moderate and severe VHD. Mean observation time was 2528 ±1454 days.

Results

Severe aortic valve stenosis (AVS) occurred in 28.2%, severe mitral valve insufficiency (MVI) in 20%. CAD with severe angiographic stenoses was noted in 42.3% (n = 434). Among patients with severe MVI, CAD was noted in 47.1% of cases, and prior acute coronary syndromes (ACS) in 27.1% of patients (n = 58). In severe AVS patients, significant angiographic atherosclerotic changes were observed in 29.6% (n = 86), and prior ACS in 7.6% (n = 22) of patients. During the observation 52.7% of patients died, including 62.9% of patients with severe MVI and 51.6% of those with severe AVS. Age (OR = 1.038; 95% CI: 1.005–1.072; p = 0.022) and coexisting aortic valve insufficiency (AVI) (OR = 2.39, 95% CI: 5.370–11.065, p = 0.035) increased the mortality rate.

Conclusions

Severe AVS is starting to be the most prevalent VHD. CAD is one of the most significant factors deteriorating prognosis of patients with VHD. AVI and age were significant risk factors for mortality. The worst prognosis was observed in severe MVI, which may result from more frequent occurrence of CAD in this group. A lesser burden of CAD and ACS in the group of patients with severe AVS did not affect survival.

Details

Title
Acute coronary syndromes and atherosclerotic plaque burden distribution in coronary arteries among patients with valvular heart disease (BIA-WAD registry)
Author
Kuźma, Łukasz; Hanna Bachórzewska-Gajewska; Kożuch, Marcin; Struniawski, Krzysztof; Pogorzelski, Szymon; Hirnle, Tomasz; Dobrzycki, Sławomir
Pages
422-430
Publication year
2019
Publication date
2019
Publisher
Termedia Publishing House
ISSN
17349338
e-ISSN
18974295
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2324908077
Copyright
© 2019. This work is published under http://creativecommons.org/licenses/by-nc-sa/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.