Key result
BAV shows similar prior MI prevalence to TAV after adjusting for age and gender.
Why the study?
The prevalence of CAD in BAV patients is debatable, and previous studies showing lower CAD prevalence versus TAV patients did not always account for age and gender.
Is the prevalence of coronary artery disease different between patients with bicuspid aortic valve and tricuspid aortic valve when adjusting for age and gender?
Systematic Review (n=60,695)
Is the prevalence of coronary artery disease different between patients with bicuspid aortic valve and tricuspid aortic valve when adjusting for age and gender?
The apparent lower prevalence of CAD in BAV patients compared to TAV patients is driven by age and gender differences rather than the valve morphology itself.
The prevalence of coronary artery disease (CAD) in bicuspid aortic valve (BAV) patients is a debatable topic. Several studies have indicated that BAV patients have a lower prevalence of CAD compared with patients with a tricuspid aortic valve (TAV), but the effects of age and gender have not always been considered. This systematic review provides an overview of articles which report on CAD in BAV and TAV patients. Searches were executed in April 2021 and January 2022 according to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-analyses) guidelines in three online databases: Medline, Embase, and Scopus. Screening and data extraction was done by two investigators separately. Primary and secondary outcomes were compared between BAV and TAV patients; a fixed effects model was used for correcting on confounders. Literature search yielded 1,529 articles with 44 being eligible for inclusion. BAV patients were younger (56.4 ± 8.3 years) than TAV patients (64 ± 10.3 years, p < 0.001). All CAD risk factors and CAD were more prevalent in TAV patients. No significant difference remained after correcting for age and gender as confounders. BAV patients have a lower prevalence of CAD and CAD risk factors compared with TAV patients. However, when the age differences between both groups are considered in the analyses, a similar prevalence of both CAD and CAD risk factors is found.
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Dolmaci et al. (2023) conducted a systematic review in Bicuspid aortic valve (n=60,695). Bicuspid aortic valve vs. Tricuspid aortic valve was evaluated on Prior myocardial infarction (OR 0.73, 95% CI 0.43-1.23, p=0.215). Bicuspid aortic valve patients have a similar prevalence of prior myocardial infarction compared to tricuspid aortic valve patients after adjusting for age and gender differences (OR 0.73).
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