Fahad Shamsi, Tariq Masood, Javaid Arif Khan.
Frequency of coronary artery disease in patients undergoing open heart valvular surgery between 30 and 45 years of age.
Pak Heart J Jan ;46(3):201-6.

Objective: This study was conducted to determine the frequency of atherosclerotic coronary artery disease in patients with rheumatic heart disease aged between 30-45 years undergoing valve replacement surgery. Methodology: It was a descriptive study of six months duration, conducted at National Institute of Cardiovascular Disease, Nazimabad, Karachi Pakistan. Patients with rheumatic heart disease (n=100) who were between 30 to 45 years of age and are scheduled for valve surgery underwent diagnostic coronary angiogram to delineate coronary arteries. Significant coronary artery disease was considered to be present if one or more coronary arteries showed 70% or more luminal stenosis. Result: The average age of the patients was 39.43+-5.51 years. There were 54% male and 46% were female. Majority of the patients had Mitral Stenosis (MS) 54(54%) followed by Mitral Regurgitation (MR) 36(36%), Aortic Stenosis (AS) 22(22%), Aortic Regurgitation (AR) 18 (18%). Of the total 100 patients, 2 (2%) patients were found to have significant (CAD). These two patients with CAD had diagnosis of aortic stenosis. Conclusion: Our results suggest that the overall frequency of coronary artery disease in patients 30-45 year of age, with rheumatic heart disease is much lower than reported in Western literature.

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