Background-Literature studies suggested a lower prevalence of coronary artery disease (CAD) in bicuspid aortic valve (BAV) than in tricuspid aortic valve (TAV) patients. However, this finding has been challenged. We performed a meta-analysis to assess whether aortic valve morphology has a different association with CAD, concomitant coronary artery bypass grafting (CABG), and postoperative mortality. Methods and Results-Detailed search was conducted according to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guideline to identify all patients with BAV or TAV and presence of CAD, concomitant myocardial surgical revascularization, and the postoperative mortality. Thirty-one studies on 3017 BAV and 4586 TAV patients undergoing aortic valve surgery were included. BAV patients showed a lower prevalence of CAD (odds ratio [OR]: 0.33; 95% CI: 0.17, 0.65), concomitant CABG (OR, 0.45; 95% CI: 0.35, 0.59), and postoperative mortality (OR, 0.62; 95% CI: 0.40, 0.97) than TAV. However, BAV subjects were significantly younger than TAV (mean difference: -7.29; 95% CI: -11.17, -3.41) were more frequently males (OR, 1.61; 95% CI: 1.33, 1.94) and exhibited a lower prevalence of hypertension (OR, 0.58; 95% CI: 0.39, 0.87) and diabetes (OR, 0.71; 95% CI: 0.54, 0.93). Interestingly, a metaregression analysis showed that younger age and lower prevalence of diabetes were associated with lower prevalence of CAD (Z value: -3.03; P=0.002 and Z value: -3.10; P=0.002, respectively) and CABG (Z value: -2.69; P=0.007 and Z value: -3.36; P=0.001, respectively) documented in BAV patients. Conclusions-Analysis of raw data suggested an association of aortic valve morphology with prevalence of CAD, concomitant CABG, and postoperative mortality. Interestingly, the differences in age and diabetes have a profound impact on prevalence of CAD between BAV and TAV. In conclusion, our meta-analysis suggests that the presence of CAD is independent of aortic valve morphology.
Impact of Valve Morphology on the Prevalence of Coronary Artery Disease : A Systematic Review and Meta-Analysis / P. Poggio, L. Cavallotti, P. Songia, A. Di Minno, P. Ambrosino, L. Mammana, A. Parolari, F. Alamanni, E. Tremoli, M.N.D. Di Minno. - In: JOURNAL OF THE AMERICAN HEART ASSOCIATION. CARDIOVASCULAR AND CEREBROVASCULAR DISEASE. - ISSN 2047-9980. - 5:5(2016), p. e003200.
|Titolo:||Impact of Valve Morphology on the Prevalence of Coronary Artery Disease : A Systematic Review and Meta-Analysis|
POGGIO, PAOLO (Primo)
CAVALLOTTI, LAURA (Secondo)
TREMOLI, ELENA (Penultimo)
|Parole Chiave:||aortic valve morphology; bicuspid aortic valve; coronary artery disease|
|Settore Scientifico Disciplinare:||Settore MED/23 - Chirurgia Cardiaca|
|Data di pubblicazione:||2016|
|Data ahead of print / Data di stampa:||mag-2016|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1161/JAHA.116.003200|
|Appare nelle tipologie:||01 - Articolo su periodico|
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