International Journal of Medical Sciences

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17 October 2017

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Int J Med Sci 2013; 10(10):1361-1366. doi:10.7150/ijms.6389

Research Paper

Predictors of Coronary and Carotid Atherosclerosis in Patients with Severe Degenerative Aortic Stenosis

Beata Bobrowska1✉, Wojciech Zasada1, Andrzej Surdacki1, Tomasz Rakowski1, Paweł Kleczyński1, Jolanta Świerszcz1, Olga Kruszelnicka2, Renata Rajtar-Salwa1, Saleh Arif1, Danuta Sorysz1, Dariusz Dudek1, Jacek S. Dubiel1

1. 2nd Department of Cardiology, Faculty of Medicine, Jagiellonian University Medical College and University Hospital, Cracow, Poland;
2. Department of Coronary Artery Disease, The John Paul II Hospital, Cracow, Poland.

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

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) License. See http://ivyspring.com/terms for full terms and conditions.
How to cite this article:
Bobrowska B, Zasada W, Surdacki A, Rakowski T, Kleczyński P, Świerszcz J, Kruszelnicka O, Rajtar-Salwa R, Arif S, Sorysz D, Dudek D, Dubiel JS. Predictors of Coronary and Carotid Atherosclerosis in Patients with Severe Degenerative Aortic Stenosis. Int J Med Sci 2013; 10(10):1361-1366. doi:10.7150/ijms.6389. Available from http://www.medsci.org/v10p1361.htm