Frequency of Coronary Artery Disease in Patients Undergoing Valvular Heart Surgery: A Retrospective Observational Study

Abstract

Objectives: Valvular heart disease (VHD) significantly impacts patients' lives and often necessitates cardiac surgery. This study aimed to assess the frequency of ischemic heart disease in patients undergoing valvular heart surgery.

Methodology: This observational study analyzed the records of 204 consecutive patients presenting to the Peshawar Institute of Cardiology between January 2021 and December 2022. All patients underwent screening angiography before surgery according to the American College of Cardiology (ACC) criteria.

Results: Among the 204 patients studied, 57.4% were male, with a mean age of 53.16 ± 12.708 years. Hypertension was the most common comorbid condition (38.2%). Mitral valve pathology was the predominant indication for valvular surgery, while isolated aortic stenosis was the most common valvular lesion observed (25%). Out of the 204 patients who underwent screening angiography, 23% had significant coronary artery disease (CAD), defined as luminal narrowing >50%. Patients younger than 40 years had a lower prevalence of significant CAD (9.8%) compared to older patients (p = 0.003). Angiographic findings revealed single-vessel disease as the most common coronary lesion (16.7%), followed by double-vessel disease (12.7%), with triple-vessel disease observed in 5.4% of cases.

Conclusion: The frequency of coronary artery disease was lower in patients younger than 40 years compared to older patients. Noninvasive investigations such as CT coronary angiography may serve as an alternative to invasive coronary angiography as a screening tool prior to cardiac surgery in older patients, if needed.