Predictors of coronary and carotid atherosclerosis in patients with severe degenerative aortic stenosis - PubMed (original) (raw)

. 2013 Aug 19;10(10):1361-6.

doi: 10.7150/ijms.6389. eCollection 2013.

Wojciech Zasada, Andrzej Surdacki, Tomasz Rakowski, Paweł Kleczyński, Jolanta Świerszcz, Olga Kruszelnicka, Renata Rajtar-Salwa, Saleh Arif, Danuta Sorysz, Dariusz Dudek, Jacek S Dubiel

Affiliations

Predictors of coronary and carotid atherosclerosis in patients with severe degenerative aortic stenosis

Beata Bobrowska et al. Int J Med Sci. 2013.

Abstract

Background: Patients with degenerative aortic stenosis (AS) exhibit elevated prevalence of coronary artery disease (CAD) and internal carotid artery stenosis (ICAS). Our aim was to investigate prevalence of significant CAD and ICAS in relation to demographic and cardiovascular risk profile among patients with severe degenerative AS.

Methods: We studied 145 consecutive patients (77 men and 68 women) aged 49-91 years (median, 76) with severe degenerative AS who underwent coronary angiography and carotid ultrasonography in our tertiary care center. The patients were divided into two groups according to the presence of either significant CAD (n=86) or ICAS (n=22).

Results: The prevalence of significant CAD or ICAS was higher with increasing number of traditional risk factors (hypertension, hypercholesterolemia, diabetes, smoking habit) and decreasing renal function. We found interactions between age and gender in terms of CAD (p=0.01) and ICAS (p=0.06), which was confirmed by multivariate approach. With the reference to men with a below-median age, the prevalence of CAD or ICAS increased in men aged >76 years (89% vs. 55% and 28% vs. 14%, respectively), whereas the respective percentages were lower in older vs. younger women (48% vs. 54% and 7% vs. 17%).

Conclusions: In severe degenerative AS gender modulates the association of age with coronary and carotid atherosclerosis with its lower prevalence in women aged >76 years compared to their younger counterparts. This may result from a hypothetical "survival bias", i.e., an excessive risk of death in very elderly women with severe AS and coexisting relevant coronary or carotid atherosclerosis.

Keywords: carotid atherosclerosis; coronary artery disease; degenerative aortic stenosis; elderly; gender..

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

Similar articles

Cited by

References

    1. Passik CS, Ackermann DM, Pluth JR, Edwards WD. Temporal Changes in the causes of aortic stenosis: a surgical pathological study of 646 cases. Mayo Clin Proc. 1987;62:119–123. - PubMed
    1. Dare AJ, Veinot JP, Edwards WD. et al. New observations on the etiology of aortic valve disease: a surgical pathologic study of 236 cases from 1990. Hum Pathol. 1993;24:1330–1338. - PubMed
    1. Iung B, Baron G, Butchart EG. et al. A prospective survey of patients with valvular heart disease in Europe: The Euro Heart Survey on Valvular Heart Disease. Eur Heart J. 2003;24:1231–1243. - PubMed
    1. Iung B, Vahanian A. Valvular heart disease in elderly people. Lancet. 2006;368:969–971. - PubMed
    1. Kannel WB, Dawber TR, Kagan A. et al. Factors of risk in the development of coronary heart disease - six year follow up experience: the Framingham study. Ann Intern Med. 1961;55:33–50. - PubMed

MeSH terms

LinkOut - more resources