A Paradoxical Association between Valvular Heart Disease and Coronary Artery Disease: A Study by Covariance Structure Analysis

Background and Aims: Coronary artery disease (CAD) constitute a major cause of cardiovascular morbidity and mortality worldwide with an enormous burden on healthcare resources. Prevalence and pattern of CAD in patients of rheumatic and non-rhemuatic valvular heart diseases varies widely with limited data on optimal strategies for diagnosis and treatment.Methods: This study includes 97 patients with rheumatic and non-rheumatic valvular heart disease who underwent coronary angiogram (CAG) before cardiac surgery. Patients were divided into two groups based on rheumatic heart disease (RHD) & non-rheumatic disease (Non-RHD) and correlate the patterns of CAD.Results: Out of 97 patients, 22 (22.6%) patients were found to have significant CAD. In patients with non-rheumatic origin CAD was common (15 patients, 68.1%) as compared to rheumatic origin (7 patients, 31. 8%). In rheumatic origin, the prevalence was 7(12.2%) out of 57 patients while in non-rheumatic origin, was 15(37.5%) out of 40 patients. In RHD group, all patients with CAD were found to have single vessel diease (SVD) while, in non-RHD group, 11 patients (73.3%) had SVD, 3 patients (16.7%) had double vessel disease (DVD) and one patient (5.6%) had triple vessel disease (TVD).Conclusions: Prevalence of CAD is higher in patients with non-RHD in comparison to those with RHD. We also found SVD to be the most common pattern of CAD in both rheumatic and non-rheumatic valvular heart disease.

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Preoperative prediction of significant coronary artery disease in patients with valvular heart disease.

BMJ ◽

10.1136/bmj.284.6311.223 ◽

1982 ◽

Vol 284 (6311) ◽

pp. 223-226 ◽

Cited By ~ 11

Author(s):

D R Ramsdale ◽

E B Faragher ◽

D H Bennett ◽

C L Bray ◽

C Ward ◽

...

Keyword(s):

Coronary Artery Disease ◽

Heart Disease ◽

Coronary Artery ◽

Valvular Heart Disease ◽

Significant Coronary Artery Disease ◽

Preoperative Prediction ◽

Artery Disease

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Cardioembolic Sources in Stroke Patients in South of Brazil

Thrombosis ◽

10.1155/2014/753780 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Luiz Carlos Porcello Marrone ◽

João Pedro Farina Brunelli ◽

Ricardo Lutzky Saute ◽

Gustavo Henrique Tomasi ◽

Bianca Cecchele Madeira ◽

...

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

Heart Disease ◽

Ischemic Stroke ◽

Coronary Artery ◽

Valvular Heart Disease ◽

Oral Anticoagulants ◽

Artery Disease ◽

South Of Brazil ◽

Toast Classification

Background. Stroke is a leading cause of mortality and disability in Brazil and around the world. Cardioembolism is responsible for nearly 30% of the origins of ischemic stroke. Methods. We analyzed data of 256 patients with cardioembolic ischemic stroke (according to TOAST classification) who were admitted into the Hospital São Lucas-PUCRS from October 2011 to January 2014. The cardioembolic subtype was divided into six subgroups: arrhythmias, valvular heart disease, coronary artery disease, cardiomyopathy, septal abnormalities, and intracardiac injuries. The prevalence of the most important cardiovascular risk factors and medications in use for prevention of systemic embolism by the time of hospital admission was analyzed in each patient. Results. Among 256 patients aged 60.2 +/− 6.9 years, 132 males, arrhythmias were the most common cause of cardioembolism corresponding to 50.7%, followed by valvular heart disease (17.5%) and coronary artery disease (16%). Hypertension (61.7%) and dyslipidemia (43.7%) were the most common risk factors. Less than 50% of patients with arrhythmias were using oral anticoagulants. Conclusions. Identifying the prevalence of cardioembolic stroke sources subgroups has become an increasingly important role since the introduction of new oral anticoagulants. In this study, arrhythmias (especially atrial fibrillation) were the main cause of cardioembolism.

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