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Aortic stenosis and coronary artery disease.
Risk factors analysis.
Claudio Magalhães Rangel
Versão Português
The objective of this report is to analyze
clinical-laboratory aspects of coronary disease in patients with
aortic stenosis and to assess the influence of risk factors for
development of obstructive coronary artery disease. Sixty-five patients with severe aortic
and surgical indication were studied. Ages ranged from 51 to 85
years (mean 68), forty were females (61,5%). Based on
cinecoronariography the patients were divided into two groups:
26 (40%) with obstructive coronary artery disease and 39 (60%)
without.Risk factors for coronary disease were
analyzed (tabacco use, dyslipidemia, diabetes mellitus,
hypertension, family history, physical inactivity and alcoholism),
clinical data, ECG, echocardiogram and laboratory examinations (glucose,
total cholesterol and fractions, triglycerides, apoprotein A1
and B, fibrinogen, Lp(a) and frational rate of triglyceride and
cholesterol removal) in both groups. The obstructive coronary
disease group demonstrated a statistically significant higher
age (p<0,0001). On ECG, ischemic signs in anterior wall
displayed a significant relationship with obstruction in
anterior intervetricular artery (p<0,002). Univariate
analysis demonstrate a significant difference between the groups
regarding the measurements of aortic gradient variables
(p=0,041), HDL (p=0,042) and fibrinogen (p=0,047). Mean gradient
and HDL were lower in the group with coronary disease than in
the group without. Mean fibrinogen levels were lower in the
group without than in those with coronary disease. Multivariate analysis by logistic regression
method revealed that fibrinogen levels (p<0,039) are an
independent variable for coronary artery disease. In conclusion
fibrinogen was an independent risk factor for the association of
coronary artery disease and aortic stenosis.
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