Lack of Association between Cholelithiasis and Significant Coronary Artery Disease: An Autopsy Study from Greece

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.