Obstructive Coronary Artery Disease in Patients Undergoing Rheumatic Valvular Heart Surgery

Authors

  • Saif Ullah National Institute of Cardiovascular Diseases, Karachi, Pakistan
  • Aamir Khowaja National Institute of Cardiovascular Diseases, Karachi, Pakistan
  • Naveed Nek Merkhand National Institute of Cardiovascular Diseases, Karachi, Pakistan
  • Raheela Khowaja National Institute of Cardiovascular Diseases, Karachi, Pakistan
  • Waqar Khan National Institute of Cardiovascular Diseases, Karachi, Pakistan
  • Ali Raza Mangi National Institute of Cardiovascular Diseases, Karachi, Pakistan
  • Suhayb Ahmad Khushk National Institute of Cardiovascular Diseases, Karachi, Pakistan
  • Jawaid Akbar Sial National Institute of Cardiovascular Diseases, Karachi, Pakistan

DOI:

https://doi.org/10.47144/phj.v56i1.2399

Abstract

Objectives: The presence of concomitant obstructive coronary artery disease (CAD) in patients with valvular heart disease (VHD) carries significant prognostic implications. Therefore, the objective of this study was to determine the frequency and severity of obstructive CAD in patients undergoing valvular heart surgery for rheumatic heart disease (RHD) at a tertiary care hospital in Karachi, Pakistan.

Methodology: This descriptive study included patients of either gender, between 40 to 70 years of age, diagnosed with RHD on transthoracic echocardiography, and undergone valvular heart surgery. As a routine, pre-operative diagnostic coronary angiography was performed and the presence and severity of obstructive CAD were recorded.

Results: Among 126 patients, 73% (92) were male, and the mean age was 48.3 ± 7.1 years. Smoking was the most common risk factor with a frequency of 22.2%, followed by hypertension (7.1%) and diabetes (4.8%). Obstructive CAD was observed in 24.6% with 19.4% single-vessel disease, 16.1% with two-vessel disease, and 64.5% with three-vessel disease. The presence of obstructive CAD was found to be positively associated with older age (p=0.040) and type of RHD (p=0.048).

Conclusion: The obstructive concomitant CAD is prevalent in around 1/4th of patients, most of them with multi-vessel diseases, undergoing valvular heart surgery for rheumatic heart disease. It has been further observed that older age and the type of RHD are positively associated with the incidence of concomitant CAD in these patients.

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Published

2023-04-01

How to Cite

1.
Ullah S, Khowaja A, Merkhand NN, Khowaja R, Khan W, Mangi AR, Khushk SA, Sial JA. Obstructive Coronary Artery Disease in Patients Undergoing Rheumatic Valvular Heart Surgery. Pak Heart J [Internet]. 2023Apr.1 [cited 2024Nov.24];56(1):61-5. Available from: https://pakheartjournal1.pcs.org.pk/index.php/pk/article/view/2399

Issue

Vol. 56 No. 1 (2023): Pakistan Heart Journal

Section

Original Article

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Copyright (c) 2023 Pakistan Heart Journal

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