Original articleAortic Valve Sclerosis: A Marker of Significant Obstructive Coronary Artery Disease in Patients with Chest Pain?
Section snippets
Study Group
This investigation was based on a retrospective review of patients selected from our echocardiographic electronic database. The study population consisted of 93 consecutive patients who met all the following inclusion criteria: (1) had been hospitalized in our department of cardiology for suggested CAD-related chest pain; (2) underwent transthoracic echocardiography and coronary angiography; (3) no previous diagnosis of cardiac ischemic disease; (4) no positive cardiac enzymes at admission to
Results
The baseline characteristics of the patients with chest pain undergoing coronary angiography are listed in Table 1. The obCAD group included 29 patients (22 men and 7 women; mean age 59 ± 11 years) and the non-obCAD group included 64 patients (33 men and 31 women; mean age 57 ± 10 years). There was a higher proportion of male patients in the obCAD group than in the non-obCAD group (76 vs 51%, P < .05). Patients with obCAD had a higher prevalence of positive reply at the stress test (67 vs 28%, P
Discussion
In this study we found that AVS is a strong independent predictor of obCAD in patients with chest pain and normal cardiac enzymes undergoing coronary angiography.
Concerning the report by Otto et al3 of a higher rate of ischemic events and increased cardiovascular mortality in patients with AVS, Carabello4 wondered whether the clinical suggestion of AVS by simple auscultation of a systolic ejection murmur and subsequent echocardiography could be part of the standard screening procedure for CAD.
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Cited by (22)
Association of Aortic Valve Sclerosis and Clinical Factors in Patients With Acute Myocardial Infarction
2019, American Journal of the Medical SciencesCardiovascular morbidity and mortality in patients with aortic valve sclerosis: A systematic review and meta-analysis
2018, International Journal of CardiologyCitation Excerpt :Moreover, after excluding studies potentially including the same population as other included studies [10,17,20,28], similar results were obtained (OR: 1.90, 95% CI: 1.56–2.31; I2: 78.7%, p < 0.001). Interestingly, a significant difference between AVSc patients and controls was confirmed both in the 11 studies [4,6,10–12,23–26,30,33] specifically evaluating myocardial infarction as outcome (OR: 2.13, 95% CI: 1.57–2.88, I2: 89.3%, p < 0.001) and in the 14 studies [8,14,16–20,28,29,31,32,34–36] defining CAD as the presence of angiographically obstructive coronary artery stenosis (OR: 2.41, 95% CI: 1.85–3.14, I2: 36.3, p = 0.086). Similar results were also confirmed after excluding the 11 studies [4,13,15,17–19,28,30,31,33,36] including controls who were not age-matched with AVSc patients (OR: 1.94, 95% CI: 1.50–2.50).
Aortic valve sclerosis as a marker of coronary artery atherosclerosis; A multicenter study of a large population with a low prevalence of coronary artery disease
2014, International Journal of CardiologyAortic valve sclerosis is a marker of atherosclerosis independently of traditional clinical risk factors. Analysis in 712 patients without ischemic heart disease
2012, International Journal of CardiologyAortic valve sclerosis and clinical outcomes: Moving toward a definition
2011, American Journal of MedicineCitation Excerpt :Utilization of the term “aortic valve sclerosis” varied widely among readers, from 3% to 36%. In the absence of a strict definition for aortic valve sclerosis and in recognition of previously reported associations of aortic valve sclerosis with cardiovascular death,6 myocardial infarction,1,6,18 and obstructive coronary artery disease,3 further insight into characteristics that influence the reporting of aortic valve appearance are needed. The Table describes the echocardiographic criteria used for defining aortic valve sclerosis in studies assessing the association of aortic valve sclerosis with outcomes.