Incidence of coronary artery disease before valvular surgery in isolated severe aortic stenosis

作     者：Eun Jeong Cho Sung-Ji Park Sung-A Chang Dong Seop Jeong Sang-Chol Lee Seung Woo Park Pyo Won Park 

作者机构：Division of Cardiology Department of Internal MedicineCardiovascular Imaging Center Cardiac and Vascular Center Samsung Medical CenterSungkyunkwan University School of Medicine Seoul Korea Department of Thorax Surgery Samsung Medical CenterSungkyunkwan University School of Medicine Seoul Korea 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2014年第127卷第22期

页      面：3963-3969页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：severe aortic stenosis coronary artery disease aortic valve replacement 

摘      要：Background Angina pectoris has been recognized as one of the principal symptoms of aortic valve stenosis （AS）,even in patients without significant coronary artery disease （CAD）.However,the incidence of angina pectoris and related CAD in such patients is *** is continuing debate as to whether coronary angiography is necessary before aortic valve replacement （AVR） in patients with severe *** purpose of this study was to evaluate the incidence and predictors of CAD in patients with severe AS in a Korean *** Data from all consecutive patients with severe AS undergoing AVR at a major tertiary cardiac and vascular center in Korea were entered in a prospective registry beginning in *** and echocardiographic follow-up data were recorded into the database *** CAD was defined as one or more major coronary arteries having an estimated narrowing of ≥70％ and left main coronary arteries having an estimated narrowing of ≥50％ on coronary *** excluded patients with multiple valve disease,significant aortic regurgitation,or prior CAD or valve *** Totally 574 patients with severe AS （mean age,（65.9±9.6） years） were enrolled in this *** CAD was found in 61 patients （10.6％）.Factors associated with increased likelihood of CAD were age,hypertension,diabetes mellitus,chronic renal failure,carotid disease,and aorta *** Logistic regression analysis,the independent predictor of the presence of CAD was age （P=0.011）.The incidence of CAD increased significantly at 69.2 years of *** two risk factors for cardiovascular disease was the most useful cutoff to predict whether a patient was going to have significant *** There was a low incidence of significant CAD in a population of Korean patients with severe ***,coronary angiography before AVR will be considered in patients with multiple risk factors for cardiovascular disease or in patients more than 69 years of