Comparative evaluation of coronary disease burden: bicuspid valve disease is not atheroprotective

Objective Bicuspid aortic valve (BAV) has been associated with less atherosclerosis as compared with tricuspid aortic valve (TAV) patients. It, however, remains unclear whether this reflects the older age of TAV patients and/or accumulation of atherosclerotic risk factors or that the BAV phenotype i...

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Main Authors: Antoine H G Driessen, Jan H N Lindeman, Robert J M Klautz, Onur Baris Dolmaci, Robert Poelmann, Nimrat Grewal
Format: Article
Language:English
Published: BMJ Publishing Group 2021-12-01
Series:Open Heart
Online Access:https://openheart.bmj.com/content/8/2/e001772.full
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author Antoine H G Driessen
Jan H N Lindeman
Robert J M Klautz
Onur Baris Dolmaci
Robert Poelmann
Nimrat Grewal
author_facet Antoine H G Driessen
Jan H N Lindeman
Robert J M Klautz
Onur Baris Dolmaci
Robert Poelmann
Nimrat Grewal
author_sort Antoine H G Driessen
collection DOAJ
description Objective Bicuspid aortic valve (BAV) has been associated with less atherosclerosis as compared with tricuspid aortic valve (TAV) patients. It, however, remains unclear whether this reflects the older age of TAV patients and/or accumulation of atherosclerotic risk factors or that the BAV phenotype is atheroprotective. Therefore, we compared the atherosclerotic disease burden of BAV and TAV patients, with that of the general (age-matched) population.Methods The prevalence of coronary artery disease (CAD) and CAD risk factors in BAV and TAV patients who underwent aortic valve surgery were compared with the Dutch general practitioners registry data. BAV (n=454) and TAV (n=1101) patients were divided into four groups: BAV with aortic valve stenosis (BAV-AoS), BAV with aortic valve regurgitation (BAV-AR), TAV with AoS (TAV-AoS) and TAV with AR (TAV-AR). The atherosclerotic disease burden of each group was compared with that of the corresponding age cohort for the general population.Results CAD risk factors hypertension and hypercholesterolaemia were more prevalent in the surgery groups than the age-matched general population (all p<0.001). All BAVs (BAV-AoS and BAV-AR) and TAV-AR had a similar incidence of CAD history as compared to the age-matched general populations (p=0.689, p=0.325 and p=0.617 respectively), whereas TAV-AoS had a higher incidence (21.6% versus 14.9% in the age-matched general population, p<0.001).Conclusions Stenotic TAV disease is part of the atherosclerotic disease spectrum, while regurgitant TAV and all BAVs are not. Although the prevalence of cardiovascular risk factors is higher in all BAV patients, the prevalence of CAD is similar to the general population.
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spelling doaj-art-00c7c3b39768477588b8f7066cfcfa1c2024-11-11T11:45:08ZengBMJ Publishing GroupOpen Heart2053-36242021-12-018210.1136/openhrt-2021-001772Comparative evaluation of coronary disease burden: bicuspid valve disease is not atheroprotectiveAntoine H G Driessen0Jan H N Lindeman1Robert J M Klautz2Onur Baris Dolmaci3Robert Poelmann4Nimrat Grewal5Department of Cardiothoracic Surgery, Heart Centre, Amsterdam UMC Locatie AMC, Amsterdam, NetherlandsDepartment of Vascular Surgery, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The NetherlandsCardiothoracic Surgery, Leiden University Medical Center, Leiden, The NetherlandsAnimal Sciences and Health, Leiden University Institute of Biology, Leiden, The NetherlandsCardiothoracic Surgery, Leiden University Medical Center, Leiden, The NetherlandsObjective Bicuspid aortic valve (BAV) has been associated with less atherosclerosis as compared with tricuspid aortic valve (TAV) patients. It, however, remains unclear whether this reflects the older age of TAV patients and/or accumulation of atherosclerotic risk factors or that the BAV phenotype is atheroprotective. Therefore, we compared the atherosclerotic disease burden of BAV and TAV patients, with that of the general (age-matched) population.Methods The prevalence of coronary artery disease (CAD) and CAD risk factors in BAV and TAV patients who underwent aortic valve surgery were compared with the Dutch general practitioners registry data. BAV (n=454) and TAV (n=1101) patients were divided into four groups: BAV with aortic valve stenosis (BAV-AoS), BAV with aortic valve regurgitation (BAV-AR), TAV with AoS (TAV-AoS) and TAV with AR (TAV-AR). The atherosclerotic disease burden of each group was compared with that of the corresponding age cohort for the general population.Results CAD risk factors hypertension and hypercholesterolaemia were more prevalent in the surgery groups than the age-matched general population (all p<0.001). All BAVs (BAV-AoS and BAV-AR) and TAV-AR had a similar incidence of CAD history as compared to the age-matched general populations (p=0.689, p=0.325 and p=0.617 respectively), whereas TAV-AoS had a higher incidence (21.6% versus 14.9% in the age-matched general population, p<0.001).Conclusions Stenotic TAV disease is part of the atherosclerotic disease spectrum, while regurgitant TAV and all BAVs are not. Although the prevalence of cardiovascular risk factors is higher in all BAV patients, the prevalence of CAD is similar to the general population.https://openheart.bmj.com/content/8/2/e001772.full
spellingShingle Antoine H G Driessen
Jan H N Lindeman
Robert J M Klautz
Onur Baris Dolmaci
Robert Poelmann
Nimrat Grewal
Comparative evaluation of coronary disease burden: bicuspid valve disease is not atheroprotective
Open Heart
title Comparative evaluation of coronary disease burden: bicuspid valve disease is not atheroprotective
title_full Comparative evaluation of coronary disease burden: bicuspid valve disease is not atheroprotective
title_fullStr Comparative evaluation of coronary disease burden: bicuspid valve disease is not atheroprotective
title_full_unstemmed Comparative evaluation of coronary disease burden: bicuspid valve disease is not atheroprotective
title_short Comparative evaluation of coronary disease burden: bicuspid valve disease is not atheroprotective
title_sort comparative evaluation of coronary disease burden bicuspid valve disease is not atheroprotective
url https://openheart.bmj.com/content/8/2/e001772.full
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