Document Detail


Mitral annular calcification: a marker of severe coronary artery disease in patients under 65 years old.
MedLine Citation:
PMID:  12527666     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Mitral annular calcification has been associated with various systemic and cardiac diseases, with a higher prevalence in women and patients over 70. A possible association between mitral annular calcification and coronary artery disease has recently been suggested. OBJECTIVE: To determine the prevalence of severe coronary artery disease in younger patients with mitral annular calcification. METHODS: Consecutive patients aged <or= 65 years with and without mitral annular calcification as detected by echocardiography were identified from a prospective clinical database. Only patients with a coronary angiogram done within one year of their qualifying echocardiogram were analysed. Severe coronary artery disease was defined as >or= 70% stenosis of at least one major epicardial coronary artery. PATIENTS: 17 735 patients were screened. Of these, 6207 (35%) had mitral annular calcification and 885 (5%) were also <or= 65 years old; coronary angiography was done in 100 of the latter (64 men; 36 women), mainly for anginal symptoms or a positive stress test. A control group (n = 121; 88 men, 33 women) was identified from 2840 consecutive patients screened. There was no significant difference between the groups in patient characteristics, indication for angiography, or atherosclerotic risk factors. RESULTS: Angiography showed a higher prevalence of severe coronary artery disease in patients with mitral annular calcification than in those without (88% v 68%, p = 0.0004), and a higher prevalence of left main coronary artery disease (14% v 4%, p = 0.009) and triple vessel disease (54% v 33%, p = 0.002). The positive predictive value of mitral annular calcification for finding severe coronary artery disease was 92%. CONCLUSIONS: In patients aged <or= 65 years, mitral annular calcification is associated with an increased prevalence of severe obstructive coronary artery disease. It may serve as a useful echocardiographic marker for the presence of obstructive coronary artery disease, especially when associated with anginal symptoms.
Authors:
S Atar; D S Jeon; H Luo; R J Siegel
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  89     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-01-15     Completed Date:  2003-03-07     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  161-4     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Calcinosis / pathology*,  ultrasonography
Cardiomyopathies / pathology*,  ultrasonography
Coronary Angiography / methods
Coronary Artery Disease / pathology
Coronary Stenosis / pathology*
Female
Heart Valve Diseases / pathology*,  ultrasonography
Humans
Male
Middle Aged
Mitral Valve*
Multivariate Analysis
Prospective Studies
Sex Factors
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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