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DOI: 10.1055/s-0044-1785190
State-of-the-Art Review

The Prevalence of Coronary Artery Disease in Bicuspid Aortic Valve Patients: An Overview of the Literature

Onur B. Dolmaci
1   Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands
2   Department of Cardiothoracic Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands
,
Tijmen L. Hilhorst
2   Department of Cardiothoracic Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands
,
Arjan Malekzadeh
3   Medical Library, Amsterdam University Medical Center, Location University of Amsterdam, Amsterdam, Netherlands
,
Bart J.A. Mertens
4   Department of Statistics, Leiden University Medical Center, Leiden, Netherlands
,
Robert J.M. Klautz
1   Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands
2   Department of Cardiothoracic Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands
,
Robert E. Poelmann
5   Institute of Biology, Leiden University, Sylvius Laboratory, Leiden, Netherlands
6   Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
,
Nimrat Grewal 
1   Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands
2   Department of Cardiothoracic Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands
7   Department of Anatomy and Embryology, Leiden University Medical Center, Leiden, The Netherlands
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Abstract

The prevalence of coronary artery disease (CAD) in bicuspid aortic valve (BAV) patients is a debatable topic. Several studies have indicated that BAV patients have a lower prevalence of CAD compared with patients with a tricuspid aortic valve (TAV), but the effects of age and gender have not always been considered. This systematic review provides an overview of articles which report on CAD in BAV and TAV patients. Searches were executed in April 2021 and January 2022 according to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-analyses) guidelines in three online databases: Medline, Embase, and Scopus. Screening and data extraction was done by two investigators separately. Primary and secondary outcomes were compared between BAV and TAV patients; a fixed effects model was used for correcting on confounders. Literature search yielded 1,529 articles with 44 being eligible for inclusion. BAV patients were younger (56.4 ± 8.3 years) than TAV patients (64 ± 10.3 years, p < 0.001). All CAD risk factors and CAD were more prevalent in TAV patients. No significant difference remained after correcting for age and gender as confounders. BAV patients have a lower prevalence of CAD and CAD risk factors compared with TAV patients. However, when the age differences between both groups are considered in the analyses, a similar prevalence of both CAD and CAD risk factors is found.

Keywords

aortic valve stenosis - atherosclerosis - bicuspid aortic valve - coronary artery disease - tricuspid aortic valve - coronary revascularization

Supplementary Material



Publication History

Received: 16 January 2023

Accepted: 07 February 2024

Article published online:
02 May 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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