SURVEY OF PREVALENCE OF CORONARY DISEASE IN AORTIC VALVE PATIENTS BEFORE VALVE REPLACEMENT SURGERY IN GOLESTAN HOSPITAL, AHWAZ FROM MAR 1996 TO MAR 2001

Coronary artery disease is one of the most common causes of death in the world. The disease have multifactorial nature but four important potential risk factors for atherosclerotic coronary artery disease include: hypertension, hyperlipidemia, smoking and diabetes mellitus. Aortic valve diseases also have multiple etiology but two of the common forms of aortic valve diseases include rheumatic and degenerative involvement. Degenerative lesion of aortic valve is associated with traditional risk factors for atherosclerosis. Echocardiography is the most important laboratory technique for evaluation and following patients with aortic valve diseases and selection for operation. Preoperative coronary angiography indicated in patients with high probability of coronary disease. If coronary disease is present, aortic valve replacement and coronary bypass graft should be performed simultaneously, because surgical risk increases when coronary disease is left untreated. Because of the differences in the reported litreture on the prevalence and the factors involved in the development of coronary diseases in different areas of the world, this retrospective study was performed in Glostan Hospital Ahwaz University of Medical Sciences, between Mar. 1996 to Mar. 2001, to determine the prevalence and predicting factors of coronary disease in all aortic valve patients that undergone preoperative coronary angiography. Ninity four patients had the criteria of this study: 58 patients were men and 36 patients were women. The results showed that only 13 patients had significant coronary disease. The patients were divided in two age groups of less or above 45 yrs old, 45 patients, and 49 patients respectively. In both groups the relation of coronary disease with four important atherosclerotic risk factors (hypertension, hyperlipidemia, smoking and diabetes mellitus) and chest pain were studied by Chi Square and Fisher Exact test. The results also showed that in younger than 45 years old, the coronary disease had significant relationship with the atherosclerotic risk factors (P<0.001) and history of chest pain (P<0.01) but these relationship was not obtained among patients 45 years age or older. The results of this study revealed low prevalence of coronary disease in aortic valve patients (13.8%) as compared with other studies (about 50%). However, similar to the previous studies, old age, major atherosclerotic risk factors and chest pain were associated with high probability of coronary disease in aortic valve patients.