Authors

• Tea Blažević — University Hospital «Sveti Duh», Zagreb, Croatia — ORCID: 0000-0003-3189-8661
• Ante Pašalić — University Hospital «Sveti Duh», Zagreb, Croatia — ORCID: 0000-0001-5989-6495
• Vera Slatinski — University Hospital «Sveti Duh», Zagreb, Croatia — ORCID: 0000-0002-8590-7589
• Edvard Galić — University Hospital «Sveti Duh», Zagreb, Croatia — ORCID: 0000-0002-5707-0961
• Jozica Šikić — University Hospital «Sveti Duh», Zagreb, Croatia — ORCID: 0000-0003-4488-0559

Abstract

**Introduction:** Aortic stenosis represents the most common valvular heart disease. It is estimated to affect 2% to 7% of the population more than 65 years of age (1). Development and progression of calcific aortic valve disease results from passive calcium deposition within the aortic valve leaflets but there is increasing evidence that this is an active cellular process. The natural history of aortic stenosis includes a latency period followed by a more or less pronounced progression. Some studies found cardiovascular risk factors to have an impact on the development of degenerative aortic valve stenosis (2) and some authors described an ‘early lesion’ that had much in common with the early lesion in atherosclerotic plaques, proposing the hypothesis of calcific aortic stenosis to be an atherosclerotic disease (3). **Patients and Methods:** We retrospectively analyzed medical documentation of all patients who were hospitalized in University Hospital “Sveti Duh” Zagreb, regardless of the indication, but with a diagnosis of aortic stenosis, during the period from October 2007 to October 2016 with the aim to evaluate the prevalence of cardiovascular risk factors. **Results:** Overall there were 915 hospitalized patients, aged 44-95 years, of which 406 (44%) men, and 330 (36%) with a history of diabetes mellitus. LDL cholesterol levels were elevated (≥3 mmol/L) in 317 (45.1%), with a value above 4.9 mmol/L in 27 (4.8%) patients. HDL levels were ≤1 mmol/L in 258 (36.9%) and triglyceride levels ≥1.7 mmol/L in 187 (26.8%) patients. There were 250 (27.3%) patients with the history of acute coronary syndrome, 119 (13%) undergoing percutaneous coronary intervention and 46 (5%) coronary artery bypass surgery. Total of 176 (19.2%) had a history of cerebrovascular disease (including stroke) and 139 (15.2%) had significant atherosclerotic lesions of carotid arteries verified with color Doppler. 75 (8.2%) had peripheral vascular disease also verified with color Doppler. **Conclusions:** With retrospective analysis of medical data we found that 45% of patients did not have adequately regulated levels of LDL cholesterol which certainly contributes to the progression of coronary, cerebral and peripheral diseases, as well as aortic stenosis.

Keywords

aortic stenosis, atherosclerosis, acute coronary syndrome

DOI

Literature

1. Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC), European Association for Cardio-Thoracic Surgery (EACTS), Vahanian A, Alfieri O, Andreotti F, Antunes MJ, Barón-Esquivias G, Baumgartner H, et al. Guidelines on the management of valvular heart disease (version 2012). Eur Heart J. 2012;33(19):2451–96. https://doi.org/10.1093/eurheartj/ehs109
2. Rossebř AB, Pedersen TR. Hyperlipidaemia and aortic valve disease. Curr Opin Lipidol. 2004;15(4):447–51. https://doi.org/10.1097/01.mol.0000137229.00020.fe
3. Otto CM. Kuusisto J, Reichenbach DD, Gown AM, O’Brien KD. Characterization of the early lesion of ‘degenerative’ valvular aortic stenosis. Histological and immunohistochemical studies. Circulation. 1994;90(2):844–53. https://doi.org/10.1161/01.CIR.90.2.844