Risk factors for degenerative aortic valve disease in India: A case control study

Abstract

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 AE 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.

Risk Factors for Calcific Aortic Valve Disease in Afghan Population

“… 12 The majority of patients with CAD do not develop aortic valve disease, despite the fact that atherosclerosis and CAVD have the same risk factors. 8 , 16 , 43 …”

“…These findings are in contrast to those of the studies conducted by Ye et al, Chadha et al, Sathyamurthy, and Picardo et al, who reported no significant association between aortic valve sclerosis and hypertension. 8,27,39,42 Vascular Health and Risk Management 2022:18 https://doi.org/10.2147/VHRM.S376955…”

“… 17 Family history of CAD was defined as disease in a first-degree male relative aged ˂ 55 years and first-degree female relative aged ˂ 55 years of age; smoking was defined as > 10 pack-years of smoking. 8 BMI was calculated for all participants, and obesity was defined as BMI ≥ 30 kg/m 2 . 18 Physical activity was classified as sedentary (nearly completely inactive); regular moderate activity (eg trying to run, heavy gardening, calisthenics) for a minimum 3 hours per week; and intense (regular hard physical preparation for competing (eg running events and racing)).…”

“… 7 It is currently recognized that an active inflammatory process such as atherosclerosis causes CAVD, rather than the previously held belief that age was the only risk factor. 8 Previous research on CAVD has shown links with risk factors for atherosclerosis, although the important variables have differed across investigations. Aronow et al studied a very senior population using 2D echocardiography and revealed that hypertension, diabetes mellitus (DM), and high total cholesterol and low HDL cholesterol levels were linked to a higher incidence of CAVD.…”

Associations between aortic regurgitation severity and risk of incident myocardial infarction and stroke among patients with degenerative aortic valve disease: insights from a large Chinese population-based cohort study

“…The risk factors involved in the development of aortic valve sclerosis were similar to that in the development of vascular atherosclerosis, including ageing, gender, hypertension, smoking, hyperlipidaemia, diabetes. 7–9 Though many studies had reported a significant association between DAVD and risk of concomitant coronary artery disease, 9 10 most of them were cross-sectional or retrospective studies, which limited their ability to infer the possible causal relationship. Moreover, some previous studies were hospital-based and only enrolled patients undergoing valve replacement treatment for severe VHDs.…”