Objective Bicuspid aortic valve (BAV) has been associated with less atherosclerosis as compared with tricuspid aortic valve (TAV) patients. It, however, remains unclear whether this reflects the older age of TAV patients and/or accumulation of atherosclerotic risk factors or that the BAV phenotype is atheroprotective. Therefore, we compared the atherosclerotic disease burden of BAV and TAV patients, with that of the general (age-matched) population. Methods The prevalence of coronary artery disease (CAD) and CAD risk factors in BAV and TAV patients who underwent aortic valve surgery were compared with the Dutch general practitioners registry data. BAV (n=454) and TAV (n=1101) patients were divided into four groups: BAV with aortic valve stenosis (BAV-AoS), BAV with aortic valve regurgitation (BAV-AR), TAV with AoS (TAV-AoS) and TAV with AR (TAV-AR). The atherosclerotic disease burden of each group was compared with that of the corresponding age cohort for the general population. Results CAD risk factors hypertension and hypercholesterolaemia were more prevalent in the surgery groups than the age-matched general population (all p<0.001). All BAVs (BAV-AoS and BAV-AR) and TAV-AR had a similar incidence of CAD history as compared to the age-matched general populations (p=0.689, p=0.325 and p=0.617 respectively), whereas TAV-AoS had a higher incidence (21.6% versus 14.9% in the age-matched general population, p<0.001). Conclusions Stenotic TAV disease is part of the atherosclerotic disease spectrum, while regurgitant TAV and all BAVs are not. Although the prevalence of cardiovascular risk factors is higher in all BAV patients, the prevalence of CAD is similar to the general population. Data are available on reasonable request.

中文翻译：

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冠状动脉疾病负担的比较评估：二尖瓣疾病没有动脉粥样硬化保护作用

与三尖瓣主动脉瓣 (TAV) 患者相比，二尖瓣主动脉瓣 (BAV) 与较少的动脉粥样硬化相关。然而，目前尚不清楚这是否反映了 TAV 患者的年龄较大和/或动脉粥样硬化危险因素的积累，或者 BAV 表型是否具有动脉粥样硬化保护作用。因此，我们比较了 BAV 和 TAV 患者与一般（年龄匹配）人群的动脉粥样硬化疾病负担。方法 将接受主动脉瓣手术的 BAV 和 TAV 患者的冠状动脉疾病 (CAD) 患病率和 CAD 危险因素与荷兰全科医生注册数据进行比较。BAV（n=454）和TAV（n=1101）患者分为四组：BAV伴主动脉瓣狭窄（BAV-AoS），BAV伴主动脉瓣关闭不全（BAV-AR），带 AoS 的 TAV (TAV-AoS) 和带 AR 的 TAV (TAV-AR)。将各组的动脉粥样硬化疾病负担与一般人群的相应年龄队列进行比较。结果 CAD 危险因素高血压和高胆固醇血症在手术组中比年龄匹配的一般人群更普遍（所有 p<0.001）。与年龄匹配的一般人群相比，所有 BAV（BAV-AoS 和 BAV-AR）和 TAV-AR 的 CAD 病史发生率相似（分别为 p=0.689、p=0.325 和 p=0.617），而 TAV-AoS发生率更高（在年龄匹配的一般人群中为 21.6% 与 14.9%，p<0.001）。结论 狭窄的 TAV 疾病是动脉粥样硬化疾病谱的一部分，而反流的 TAV 和所有 BAV 都不是。尽管在所有 BAV 患者中心血管危险因素的患病率较高，CAD 的患病率与一般人群相似。可应合理要求提供数据。