# Concentration of Trace Elements in Patients with Aortic Stenosis and Coexisting Coronary Artery Disease: A Pilot Study

## TL;DR

This pilot study found that patients with aortic stenosis and coronary artery disease have lower levels of certain trace elements in their blood compared to those with only aortic stenosis.

## Contribution

The study is the first to compare trace element concentrations in patients with aortic stenosis with and without coexisting coronary artery disease.

## Key findings

- Patients with CAD had lower median concentrations of aluminum and calcium in peripheral blood and manganese and selenium in aortic blood.
- Advanced CAD patients showed lower levels of magnesium, calcium, nickel, and copper in peripheral blood and chromium and selenium in aortic blood.
- Lower selenium in aortic blood was predictive of advanced CAD stages.

## Abstract

Background/Objectives: Coronary artery disease (CAD) and aortic stenosis (AS) frequently coexist and share similar pathophysiological pathways, including inflammation, lipid deposition, and extracellular matrix remodeling. Trace elements are involved in cellular and physiological processes, playing regulatory and signaling roles. Their concentrations may be altered in various pathological conditions. The aim of our study was to compare trace metal concentrations in patients with severe aortic stenosis with and without coexisting coronary artery disease. Methods: In 53 patients (25 male, 47.2%, median age of 78 (75–81) years) with severe aortic stenosis, CAD coexistence and progression were analyzed based on the most recent coronary angiography report and history of revascularization. Blood samples for trace element analysis were collected prior to the implantation of the prosthesis, from the peripheral artery and by the pigtail catheter at the aortic root. Results: Twenty-six patients presented any degree of CAD, and were further differentiated into more advanced disease stages. The analysis found that patients with CAD had lower median concentrations of aluminum and calcium in the peripheral blood, and manganese and selenium in the aorta. Furthermore, in most advanced CAD patients, the concentration of magnesium, calcium, nickel, and copper in peripheral blood, along with chromium and selenium in aortic blood, was found to be lower compared to non-CAD patients. Lower selenium in aortic blood samples was predictive of an advanced stage of CAD. Conclusions: Patients with severe aortic stenosis and coexisting CAD present significantly lower blood concentrations of trace elements compared to those with the isolated disease.