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Despite improvements in risk scoring of severity of CAD, there are still low-risk patients who experience CHD events.
Aim of study
To evaluate the correlation between the severity of Mitral Annular Calcification and the extent of CAD.
Fifty patients with suspected coronary artery disease and less than 65 years, referred for diagnostic coronary angiography for evaluation of chest pain between January 2015 and April 2017. The study subjects were divided into: Group I - Twenty patients with normal aortic and mitral valves; Group II -Thirty patients with mitral annulus calcification without congenital or rheumatic or dialysis were enrolled.
After consent, patients were subjected to history, clinical evaluation, lab, and ECG. Thickness of mitral leaflets and their motion were assessed. The severities of coronary artery disease were graded according to Friesinger score, which ranges from 0 to 15. Each of the three main coronary arteries is scored separately from 0 to 5. Score 0: No arteriographic abnormality, Score 1: Trivial irregularities (lesion from 1-29%), Score 2: Localized 30-68% luminal narrowing, Score 3: Multiple 30-68% luminal narrowing of same vessel, Score 4: 69-100% luminal narrowing without 100% occlusion of proximal segments, and Score 5: Total obstruction of a proximal segment of a vessel.
Friesinger score is significantly higher in Group II (9.53 ± 2.36) compared to Group I (2.5±2.2) (P < 0.001). No significant difference between the groups in patient characteristics. Angiography showed a higher prevalence of CAD in patients in group II than in group I (88% vs. 68%, p = 0.0004), and a higher prevalence of left main CAD (14% vs. 4%, p = 0.009) and triple vessel disease (54% vs. 33%, P = 0.002).
The association of mitral annulus calcification is strongly positively correlated with extend and severity of CAD.