Lack of Association between Cholelithiasis and Significant Coronary Artery Disease: An Autopsy Study from Greece
Christos Soutis *
Department of Legal Medicine, Hellenic Ministry of Justice, Piraeus, Greece.
Chara Spiliopoulou
Department of Forensic Medicine and Toxicology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Nikolaos Goutas
Department of Forensic Medicine and Toxicology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Alexandra Ampati
DNA Analysis Laboratory, Department of Legal Medicine, Hellenic Ministry of Justice, Athens, Greece.
Eleni Zorba
Department of Forensic Medicine and Toxicology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Anastasia Antoniou
2nd Department of Psychiatry, “Attikon” University General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Efstathios Skliros
Nemea Health Center, Corinthia, Greece.
Stavroula Papadodima
Department of Forensic Medicine and Toxicology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
*Author to whom correspondence should be addressed.
Abstract
Aims: Cholelithiasis or Gallstone disease and coronary artery disease have been reported to share several common risk factors. The aim of this study was to examine if there is an association between coronary artery disease (CAD) and gallstone disease (GsD) through an autopsy study.
Methodology: A retrospective analysis of the records of consecutive autopsy cases performed at the Department of Forensic Medicine and Toxicology of the National and Kapodistrian University of Athens during the period from January 1, 2011, to December 31, 2015, was performed. The inclusion criteria were age between 35 and 65 years old. Our sample consisted of 1699 cases. Significant CAD was defined as stenosis of the lumen equal to or over 75% in any major coronary artery.
Results: Significant CAD was found in 656 (38.6%) cases. Results showed that age, male sex, hypertension, smoking (P <0.001), presence of diabetes mellitus (DM)(P =0.005), hyperlipidemia (P =0.001), and illicit drug use (P =0.006) were statistically significant predictors of significant CAD presence. On the contrary, heavy alcohol use (P =0.069), GsD (P =0.838) and cholecystectomy (P =0.423) was not found to be related to significant CAD.
Conclusion: Our study did not show any statistically significant relationship between the presence of significant coronary artery stenosis and GsD. The same outcome was noticed when cholecystectomy was studied separately. Therefore, cholelithiasis and cholecystectomy cannot serve as possible predictors for CAD development. Future studies are needed to validate our findings that will lead to more beneficial prevention planning and monitoring of patients so as to maximize resources management and reduce healthcare costs.
Keywords: Gallstone disease, cholelithiasis, gallstones, coronary artery disease, coronary artery stenosis, autopsy study