Korean J Med.  2012 Jul;83(1):75-82.

Prevalence of Significant Coronary Arterial Disease in Adult Patients who Underwent Valvular Surgery in Korea

• Choi UL
• Lee SH
• Park JH
• Seong SW
• Kim JH
• Lee JH
• Choi SW
• Jeong JO
• Seong IW
• Rhee KS
• Chae JK
• Kim WH
• Ko JK
• Na MH
• Lim SP
• Kim KH
• Choi JB

Abstract

BACKGROUND/AIMS
The identification of significant coronary arterial disease (CAD) is important to reduce perioperative ischemic insult and the possibility of repeated open-chest surgery in patients scheduled to undergo valvular surgery. However, there are no published data on the incidence of significant CAD in these patients. Thus, we examined the prevalence of significant CAD in patients scheduled to undergo valvular surgery.
METHODS
From January 2005 to June 2011, all consecutive adult patients diagnosed with significant valvular disease and scheduled for an elective open valvular operation were retrospectively investigated at Chungnam National University Hospital and Chonbuk National University Hospital. Patients who underwent emergent valvular operations due to acute aortic dissection or trauma and concomitant valvular operations at the time of coronary artery bypass graft (CABG) surgery were excluded.
RESULTS
During the study period, a total of 431 patients (58 +/- 13 years old, 204 males) were included. The distributions of mitral (241 patients) and aortic valvular disease (230 patients) were similar. Coronary angiography was performed in 297 patients (68.9%). Of these, 36 (12.1%) showed significant CAD and 32 underwent concomitant CABG operations. Based on a multivariate analysis, the presence of CAD was significantly associated with old age (> or = 65 years old) [odds ratio (OR) = 3.081, 95% confidence interval (CI) = 1.372-6.921, p = 0.006], more cardiovascular risk factors (> or = 3) (OR = 3.002, 95% CI = 1.386-6.503, p = 0.005), and the presence of aortic stenosis (OR = 2.763, 95% CI = 1.269-6.013, p = 0.010).
CONCLUSIONS
The incidence of significant CAD was 12.1% in adult patients who underwent valvular operations in Korea. CAD was more common in patients with old age, aortic stenosis, and multiple cardiovascular risk factors.

Keyword

Coronary angiography; Coronary artery disease; Heart valve disease

MeSH Terms

Adult
Aortic Valve Stenosis
Coronary Angiography
Coronary Artery Bypass
Coronary Artery Disease
Heart Valve Diseases
Humans
Incidence
Korea
Multivariate Analysis
Prevalence
Retrospective Studies
Risk Factors
Transplants