Gender differences in clinical factors associated with coronary artery atherosclerosis severity in patients with aortic valve and/or mitral annulus calcification

Objective: Introduction: The previous studies of coronary atherosclerosis association with aortic valve calcification (AVC) and/or mitral annulus calcification (MAC) had contradictory results. The aim: To assess gender differences in clinical factors associated with coronary artery atherosclerosis severity.

Patients and methods: Materials and methods: 362 patients (mean age 63.9 (8.8) years, 244 (67.4%) males) who underwent coronary angiography were included in the retrospective study. AVC and/or MAC presence was determined using transthoracic echocardioscopy. Coronary angiography results were assessed using coronary atherosclerosis severity index (CASI).

Results: Results: There were lower CASI in aortic stenosis (AS) subgroups (0 (0; 3.5) and (0; 9.5) in subgroups with severe and moderate AS respectively versus 12.0 (6.0; 20.5) in subgroup without AS, <0.005). Man with AVC and/or MAC (without AS and diabetes mellitus (DM)) had higher CASI compared to man without heart valve calcification and without DM (15.0 (7.0; 21.5) versus 7.0 (2.0; 12.0), p=0.0002), whereas in the similar woman subgroups CASI did not differ. In the male group without DM (without AS) CASI was associated with age (r=0.319, <0.0001), glomerular filtration rate (GFR) (r=(-0.164), p=0.049), cholesterol level (r=0.242, p=0.003) and the combined presence of AVC and MAC (r=0.229, p=0.006), whereas in the similar female group there were only CASI association with GFR (r=(-0.252), p=0.050) and with combined presence of AVC and MAC (r=0.219, p=0.080).

Conclusion: Conclusions: CASI depended on AS severity. In subgroups without AS and DM CASI was associated with combined presence of AVC and MAC, GFR, and besides with age and cholesterol level in man.