Background: Studies on the association between aortic valve sclerosis (AVSc) and diabetes in patients with coronary artery disease (CAD) are lacking.In this retrospective observational study, we evaluated the association of AVSc with diabetes and to assess the risk of all-cause mortality in patients referred to isolated coronary artery bypass surgery (CABG).
Methods: Echocardiograms obtained at the baseline from 2’327 patients undergoing CABG between 2006 and 2016 in a single center were assessed. The follow-up was carried out through a regional registry. Hazard ratios (HR) were adjusted for clinical factors [i.e., sex, age, previous myocardial infarction, ejection fraction (EF), dyslipidemia, and kidney function].
Results: Overall, AVSc was present in 1’116 (39.7%) and diabetes in 840 patients (29.9%). Diabetic patients showed a significant higher AVSc prevalence compared to nondiabetic patients (44 vs. 38%, respectively; p=0.005).In 5 years follow-up, 479 deaths (20.6%) for any cause were registered. Independent predictors of all-cause mortality were age (p<0.001), EF (p<0.001), AVSc (p=0.02), and diabetes (p=0.004).We stratified the patients into three groups: A) no-diabetes and no-AVSc; B) diabetes or AVSc; C) diabetes and AVSc. The mortality rate was 18.6% in group A, 20.8% in group B, and 26.5% in group C. Group B and C had a significant increased overall mortality risk with a HR of 1.4 (p=0.04) and 2.1 (p<0.001), respectively, when compared to group A. The HR of group C was also significantly higher than group B (HR=1.5; p=0.03).
Conclusions: Our findings indicate that: 1) AVSc is associated with diabetes; 2) AVSc and diabetes are independently associated with all-cause mortality in patients undergoing CABG; and 3) patients with both clinical conditions have the highest mortality rate. These data improve risk stratification in patients undergoing surgical myocardial revascularization.
V.A. Myasoedova: None. S. Genovese: Advisory Panel; Self; Novartis Pharmaceuticals Corporation, Sanofi. Consultant; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Hikma Pharmaceuticals. Speaker's Bureau; Self; Eli Lilly and Company, Merck Sharp & Dohme Corp., Mundipharma, Novo Nordisk A/S, Takeda Pharmaceutical Company Limited. L. Cavallotti: None. A. Bonomi: None. P. Gripari: None. J. Campodonico: None. V. Valerio: None. M. Rondinelli: Consultant; Self; Sanofi. Speaker's Bureau; Self; Eli Lilly and Company, Merck Sharp & Dohme Corp., Takeda Pharmaceutical Company Limited. P. Songia: None. M. Pepi: None. F. Alamanni: None. P. Poggio: None.
Fondazione Gigi e Pupa Ferrari ONLUS