Why the study?
Are traditional cardiovascular risk factors independently associated with severe aortic stenosis when matched for coronary artery disease prevalence?
Are traditional cardiovascular risk factors independently associated with severe aortic stenosis when matched for coronary artery disease prevalence?
Cardiovascular risk factors do not independently predict the prevalence of aortic stenosis when controlling for concomitant coronary artery disease, suggesting other factors drive its pathogenesis.
Answers are grounded in this paper and cite their sources.
Traditional risk factors may not independently predict aortic stenosis beyond CAD; leaves open nontraditional pathogenic drivers.
BACKGROUND: Traditional cardiovascular risk factors have been associated with aortic stenosis and coronary artery disease. As these two conditions often co-exist, the association of cardiovascular risk factors with aortic stenosis may reflect confounding. OBJECTIVE: To compare the cardiovascular risk profile in patients with severe aortic stenosis undergoing elective coronary angiography with that of patients without aortic stenosis or calcification undergoing coronary angiography for suspected coronary artery disease. METHODS: 523 patients referred for elective diagnostic left heart catheterisation because of severe aortic stenosis formed the case population; 3925 patients without valve disease referred for elective diagnostic left heart catheterisation formed the base control population. Of the latter, 523 were pair matched to the case population for sex, age, and prevalence of relevant coronary artery disease, forming a pair matched control population. Cardiovascular risk factors (male sex, hypertension, hypercholesterolaemia, smoking, diabetes mellitus, family history of coronary artery disease) were assessed in all the patients. RESULTS: None of the cardiovascular risk factors was more prevalent in patients with aortic stenosis than in the base control population or in the pair matched control population. However, male sex, hypercholesterolaemia, smoking, diabetes mellitus, and a family history of coronary artery disease were significantly associated with the presence of additional coronary artery disease in patients with aortic stenosis. CONCLUSIONS: Cardiovascular risk factors are commonly present in patients with aortic stenosis. However, when compared with controls matched for age, sex, and angiographically defined coronary artery disease, no risk factor was significantly associated with the prevalence of aortic stenosis. Thus other factors are likely to be more important in the pathogenesis of aortic stenosis.
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Jan R. Ortlepp (2003) studied this question.
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