Chadha D S, Malani S K, Bharadwaj P, Karthikeyan G, Hasija P K
Senior Advisor (Medicine & Cardiology), Command Hospital (Air Force), Bangalore, India.
Consultant (Medicine & Cardiology), Command Hospital (Central Command), Lucknow, UP, India.
Med J Armed Forces India. 2018 Jan;74(1):33-37. doi: 10.1016/j.mjafi.2017.03.004. Epub 2017 Apr 18.
BACKGROUND: Degenerative aortic valve disease often co-exists with coronary artery disease (CAD) and studies done in western populations have shown that it shares the same risk factors which cause CAD. However little is known in this context among Asian Indians. The current study looks into the risk factors of degenerative aortic valve disease in Asian Indian population. METHODS: Ninety-one consecutive patients with severe aortic stenosis (AS) reporting for left heart catheterization prior to valve replacement surgery at a tertiary care centre were recruited for the study. They were compared with age and sex matched controls selected from a database of 3200 patients referred for elective diagnostic left heart catheterization for suspected CAD. Following traditional cardiovascular risk factors were assessed in all patients: age, gender, family history of CAD, smoking history, presence of diabetes, hypertension and dyslipidemia. RESULTS: The mean age of the study population was 57.8 ± 8.2 years (range, 40-80 years). Smoking, family history of CAD and hypercholesterolemia were significantly more prevalent in patients with degenerative AS compared to those with normal valves. No significant difference was noted in the presence of diabetes mellitus. On multivariate logistic regression, family history of premature CAD (OR 3.68; CI 1.38-9.78) smoking history (OR, 2.56; CI, 1.21-5.39), and raised LDL levels (OR, 5.55; CI, 2.63-11.69) were independently associated with the aortic stenosis patient cohort. CONCLUSIONS: The study showed a significant association of cardiovascular risk factors with aortic stenosis independent of age and gender in Asian Indian patients.
背景:退行性主动脉瓣疾病常与冠状动脉疾病(CAD)并存,西方人群的研究表明,它与导致CAD的风险因素相同。然而,在亚洲印度人群中,这方面的了解甚少。本研究旨在探讨亚洲印度人群中退行性主动脉瓣疾病的风险因素。 方法:本研究招募了91例在三级医疗中心接受瓣膜置换手术前进行左心导管检查的重度主动脉瓣狭窄(AS)患者。将他们与从3200例因疑似CAD接受择期诊断性左心导管检查的患者数据库中选取的年龄和性别匹配的对照组进行比较。对所有患者评估以下传统心血管危险因素:年龄、性别、CAD家族史、吸烟史、糖尿病、高血压和血脂异常。 结果:研究人群的平均年龄为57.8±8.2岁(范围40 - 80岁)。与瓣膜正常的患者相比,退行性AS患者中吸烟、CAD家族史和高胆固醇血症更为普遍。糖尿病的存在无显著差异。多因素逻辑回归分析显示,早发CAD家族史(OR 3.68;CI 1.38 - 9.78)、吸烟史(OR 2.56;CI 1.21 - 5.39)和低密度脂蛋白水平升高(OR 5.55;CI 2.63 - 11.69)与主动脉瓣狭窄患者队列独立相关。 结论:该研究表明,在亚洲印度患者中,心血管危险因素与主动脉瓣狭窄存在显著关联,且独立于年龄和性别。
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