Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Introduction The most recent European Society of Cardiology guideline on coronary syndromes recommends echocardiography in all patients with suspected coronary artery disease (CAD). Whereas left ventricular function (LVF) is recognized as an important determinant of major adverse cardiovascular events (MACE) in these patients, little is known about the role of valvular heart disease (VHD). Purpose The aim of this study was to evaluate the prevalence and impact on the prognosis of VHD in patients referred for suspected CAD. Method Baseline, treatment and event in follow-up data of patients with suspected CAD who underwent transthoracic echocardiography (TTE) in a tertiary center between 2014 and 2021 were collected. MACE were defined as all-cause death, nonfatal stroke and nonfatal myocardial infarction (MI). VHD was defined as moderate-or-severe aortic stenosis (AS) or mitral regurgitation (MR). LV dysfunction was defined an ejection fraction less than 50%. Time-to-first-event analysis was performed with Kaplan-Meier survival curves and Cox proportional hazard analysis adjusting for significant covariates and time-dependent interventions. Results A total of 845 patients (57% men) with mean age of 65 years were identified. The median follow-up time was 2.8 years (1.1 – 4.8). In total 144 MACE (108 all-cause death, 14 nonfatal stroke, 22 nonfatal MI) occurred. VHD was prevalent in 132 (16%) patients of which 95 patients had moderate or severe AS and 44 had moderate or severe MR, see Figure 1. Independent determinants of MACE in VHD patients included moderate or severe VHD (HR 1.5, p = 0,05), LV dysfunction (HR 2.1, p < 0.001), age older than 70 years (HR 1.7, p = 0.003) and diabetes (HR 2.0, p < 0.001). Conclusion There is a high prevalence of VHD in patients referred for suspected CAD. Moderate to severe VHD strongly determines the prognosis. Future studies are needed to determine whether valvular interventions can improve the long-term outcome. Abstract Figure.

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