Coronary Arterial Disease in Patients of Aortic Stenosis and Associated In-Hospital Complications after Surgical Management

Abstract

Objectives: This study aimed to determine the frequency of coronary artery disease (CAD) and its complications following surgical management in patients with aortic stenosis (AS).

Methodology: This descriptive case series included 113 patients, both male and female, aged between 40 and 80 years, diagnosed with severe AS. All patients underwent coronary angiography prior to surgical management to assess the presence of CAD. Postoperatively, patients were monitored during their hospital stay for up to 72 hours, and complications such as major bleeding, acute kidney injury (AKI), stroke, and mortality were recorded.

Results: The study included 113 patients with a mean age of 55.4±12.4 years, of whom 63 (55.8%) were male. Positive family history of CAD was found in 24 (21.2%) patients. CAD was observed in 65 (56.6%) patients. In-hospital complications were as follows: major bleeding occurred in 7 (6.2%) patients, AKI in 13 (11.5%), stroke in 10 (8.8%), and mortality in 3 (2.7%) patients. Mortality rates were 4.7% vs. 0% (p=0.125), stroke rates were 14.1% vs. 2% (p=0.026), and AKI rates were 17.2% vs. 4.1% (p=0.023) for patients with and without CAD, respectively.

Conclusion: The prevalence of CAD was found to be high in more than half of the patients with severe AS. The presence of CAD was associated with an increased risk of mortality and complications such as stroke and AKI. It is crucial to identify the underlying risk factors for CAD in this patient population in order to effectively address the burden of the disease and optimize management strategies accordingly.