Key result
The overall prevalence of coronary artery disease in patients undergoing non-coronary cardiac surgery was 8.7%, with a significantly higher prevalence in valvular heart disease (P<0.05).
Cross-Sectional (n=300)
Absolute Event Rate: 9.3% vs 3.3%
p-value: p=< 0.05
Pre-operative coronary angiography reveals a significant CAD prevalence of 8.7% in patients undergoing non-coronary cardiac surgery, particularly high in those with degenerative aortic valve disease.
May inform selective CAD screening before valvular surgery; leaves open impact on outcomes.
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. CONCLUSION: 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%).
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Manjunath et al. (2014) conducted a cross-sectional in Non-coronary cardiac lesions (n=300). Valvular heart disease vs. Non-valvular heart disease was evaluated on Significant coronary artery disease (CAD) (p=< 0.05). The overall prevalence of coronary artery disease in patients undergoing non-coronary cardiac surgery was 8.7%, with a significantly higher prevalence in valvular heart disease (P<0.05).
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