Prediction of severity of coronary artery atherosclerosis in patients with cardiac valves calcinosis depending on gender
Gender features of clinical factors associated with severity of coronary arteries atherosclerosis was investigated in patients who underwent coronary arteriography (CA) and possible prediction of coronary atherosclerosis severity was estimated. CA results was assessed using coronary atherosclerosis severity index (CASI) that represent coronary atherosclerosis severity and extension. Patients with heart valves calcinosis (HVC) and severe aortic stenosis (AS) has significantly lesser CASI compared with HVC patients without AS (0 (0; 3,5) in group with grade 3 of AS and 3,0 (0; 10,0) in group with grade 2 of AS compared with 12,0 (5,5; 20,0) in group without AS, р<0,010). Patient with coronary artery disease (CAD) and HVC more often had myocardial infarction (odds ratio 2,04 for men and 2,35 for women). CASI was higher in group with combined presence of aortic valve calcification (AVC) and mitral annular calcification (MAC) (16,25 (7,0; 24,5) in group with combined presence of AVC and MAC; 11,5 (5,0; 19,0) in group of isolated AVC and 8,5 (3,5; 18,5) in group of isolated MAC, Рisol.AVC-comb.lesion=0,023). Correlation analysis (CASI association with age, body mass index (BMI), smoking, hypertension, diabetes mellitus (DM), cholesterol level, glomerular filtration rate (GFR) and type of calcific valves lesion was analyzed) revealed CASI association with age (r=0,248, р=0,006), cholesterol level (r=0,186, р=0,011), DM (r=0,126, р=0,085) and combined presence of AVC and MAC (r=0,149, р=0,042) in male group and with DM (r=0,212, р=0,0046), GFR (r=(-0,251), р=0,018) and combined presence of AVC and MAC (r=0,220, р=0,038) in female. Possibility of CASI prediction was evaluated by using stepwise logistic regression analysis. For men CASI significant predictive factors included age, cholesterol level, DM and combined presence of AVC and MAC and for women only combined presence of AVC and MAC was significant predictive factor.
2. Kovalenko, V.M., & Kornatskyi V.M. (Red.) (2017). Problemy zdorovia i tryvalosti zhyttia v suchasnykh umovakh. Kyiv: b.v. [in Ukrainian].
3. Atar, S., Jeon, D.S., Luo, H. & Siegel, R.J. (2003). Mitral annular calcification: a marker of severe coronary artery disease in patients under 65 years old. Heart, 89, 161-164.
4. Avakian, S.D., Annicchino-Bizzacchi, J.M., Grinberg, M., Ramires, J.A., & Mansura, A.P. (2001). Apolipoproteins AI, B, and E polymorphisms in severe aortic valve stenosis. Clin. Genet., 60(5), 381-384.
5. Baumgartner, H., Hung, J., Bermejo, J., Chambers, J.B., Evangelista, A., Griffin, B.P. … Quiñones, M. (2009). Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. Eur. J. Echocardiogr., 10(3), 479.
6. Bella, J.N., Tang, W., Kraja, A., Rao, D.C., Hunt, S.C., Miller, M.B. … Arnett D.K. (2007). Genome-Wide Linkage Mapping for Valve Calcification Susceptibility Loci in Hypertensive Sibships. The Hypertension Genetic Epidemiology Network Study. Hypertension, 49, 453.
7. Freeman, R.V., & Otto, C.M. (2005). Spectrum of Calcific Aortic Valve Disease Pathogenesis, Disease Progression, and Treatment Strategies. Circulation, 111, 3316-3326.
8. Henein, M., Hallgren, P., Holmgren, A., Sörensen, K., Ibrahimi, P., Kofoed, K.F. … Hassager, C. (2015). Aortic root, not valve, calcification correlates with coronary artery calcification in patients with severe aortic stenosis: A two-center study. Atherosclerosis, 243, 631-637.
9. Nightingale, A.K., & Horowitz, J.D. (2005). Aortic sclerosis: not an innocent murmur but a marker of increased cardiovascular risk. Heart, 91, 1389-1393.
10. Novaro, G.M., Sachar, R., Pearce, G.L., Sprecher, D.L., & Griffin, B.P. (2003). Association Between Apolipoprotein E Alleles and Calcific Valvular Heart Disease. Circulation, 108, 1804-1808.
11. Ortlepp, J.R., Schmitz, F., Mevissen, V., Weiss, S., Huster, J., Dronskowski, R. … Hoffmann, R. (2004). The amount of calcium-deficient hexagonal hydroxyapatite in aortic valves is influenced by gender and associated with genetic polymorphisms in patients with severe calcific aortic stenosis. European Heart J., 25(6), 514-522.
12. Probst, V., Le Scouarnec, S., Legendre, A., Jousseaume, V., Jaafar, P., Nguyen, J.M. … Schott, J.J. (2006). Familial Aggregation of Calcific Aortic Valve Stenosis in the Western Part of France. Circulation, 113, 856-860.
13. Utsunomiya, H., Yamamoto, H., Kunita, E., Kitagawa, T., Ohashi, N., Oka, T. … Kihara, Y. (2010). Combined presence of aortic valve calcification and mitral annula calcification as a marker of the extent and vulnerable characteristics of coronary artery plaque assessed by 64-multidetector computed tomography. Atherosclerosis, 213(1), 166-172.
14. Windecker, S., Kolh, P., Alfonso, F., Collet, J.P., Cremer, J., Falk, V. … Witkowski A. (2014). ESC/EACTS Guidelines on myocardial revascularization. The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). European Heart Journal, 35(37), 2541–2619.
15. Yamamoto, H., Shavelle, Takasu, J., Lu, В., Mao, S.S., Fischer, H. & Budoff, M.J.2003). Valvular and thoracic aortic calcium as a marker of the extent and severity of angiographic coronary artery disease. American Heart Journal, 146, Issue 1, 153–159.