Coronary artery disease in patients undergoing cardiac surgery for non-coronary lesions in a tertiary care centre

Indian Heart J. 2014 Jan-Feb;66(1):52-6. doi: 10.1016/j.ihj.2013.12.014. Epub 2013 Dec 28.

Abstract

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%).

Keywords: Coronary artery disease; Preoperative coronary angiogram; Prevalence.

MeSH terms

  • Adult
  • Age Distribution
  • Cardiac Surgical Procedures / methods
  • Chi-Square Distribution
  • Cohort Studies
  • Comorbidity
  • Coronary Angiography / methods
  • Coronary Artery Disease / diagnostic imaging*
  • Coronary Artery Disease / epidemiology*
  • Echocardiography, Doppler
  • Female
  • Follow-Up Studies
  • Heart Valve Diseases / diagnostic imaging
  • Heart Valve Diseases / epidemiology*
  • Heart Valve Diseases / surgery*
  • Humans
  • Incidental Findings
  • India
  • Male
  • Middle Aged
  • Preoperative Care / methods
  • Prevalence
  • Retrospective Studies
  • Rheumatic Heart Disease / diagnostic imaging
  • Rheumatic Heart Disease / epidemiology
  • Rheumatic Heart Disease / surgery
  • Risk Assessment
  • Sex Distribution
  • Tertiary Care Centers
  • Treatment Outcome