[Indications for coronary angiography in patients with acquired heart valve diseases with reference to risk factors].

The aims of the study were to examine the frequency of coronary artery disease (CAD) in patients with acquired valvular heart disease and to investigate the parameters by which significant coronary artery stenosis can be identified without invasive measures in these patients. For this reason 266 consecutive patients with acquired valvular heart disease (aortic, mitral or combined lesions) were examined retrospectively. In 24 patients (9%) a significant (50% or more reduction of the diameter) coronary artery stenosis was found. The prevalence of CAD increased with age: only one patient younger than 50 years, but 23 patients (13%) older than 50 years revealed significant CAD (19% men, 7% women). Increased levels of cholesterol and/or triglycerides were found more frequently in patients with CAD (33% and 29%, respectively) than in those without (6% and 12%, respectively). No differences were found in patients with aortic and mitral valve disease. Patients with typical chest pain revealed CAD in 30% of cases, whereas only 5% of the patients without angina pectoris (or 4% with atypical chest pain) showed a significant coronary artery stenosis. A high percentage (62%) of patients with typical chest pain and mitral valve disease revealed CAD. None of the 77 female patients without typical angina pectoris had significant coronary artery stenosis, whereas 11% of the male patients showed significant CAD even without typical symptoms. In 51 patients without typical angina pectoris and with no risk factors, no CAD was observed.(ABSTRACT TRUNCATED AT 250 WORDS)