Background: We attempted to evaluate the prevalence of coronary artery disease in Chinese adults with severe rheumatic mitral stenosis.
Methods: We prospectively performed coronary angiography in 119 consecutive Chinese patients older than 40 years old (mitral valve area less than 1.5 cm2) who were about to undergo balloon mitral commissurotomy for significant rheumatic mitral stenosis. The exclusion criteria were the presence of left atrial cavitary thrombi or mitral regurgitation greater than grade 3.
Results: There were 32 men (26%) and 87 women (74%) with a mean age of 55 +/- 9.7 years (ranging from 40 to 78). Ninety-two patients (77%) were in atrial fibrillation. The prevalence of risk factors for atherosclerotic cardiovascular disease were hypertension (22%), diabetes mellitus (4%), hypercholesterolemia > or = 240 mg/dL (5%), hypertriglyceridemia > or = 150 mg/dL (13%), and cigarette use (7%). Coronary artery disease on angiography was defined as stenosis of more than 50% of the luminal diameter. We found that only 2 patients (1.7%) had coronary artery disease.
Conclusion: The prevalence of coronary artery disease was much lower than in previous reports, some of which, however, had already pointed out the relatively low prevalence of coronary artery disease in rheumatic mitral disease. The definite mechanisms require further study.