Background: Our aim of this study was to find the prevalence of CAD and various CAD risk factors in RHD patients < 50 years.

Materials and Method: It was a single center observational retrospective study of 6324 rheumatic heart disease patients, who underwent Coronary Angiography (CAG) prior to surgical valvular replacement from January 2011 to December 2017. Among them 3920 patients were < 50 years of age, they were included in this study. Patients with age > 50 years (2404) were excluded. Among them significant CAD group patients (stenosis ≥50% -Group A), were compared with similar age group matched patients of RHD without CAD (Group B).

Results: The overall prevalence of CAD in the patients undergoing valvular intervention was 5.68% (61.88% males, 38.12% female). The CAD incidence in patients with mitral, aortic and both valve replacement were 8.20%, 62.5%
and 29.3% respectively. The prevalence of smoking (41.7% vs. 27.48%), diabetes (18.83% vs. 3.62%), hypertension (69.05% vs. 13.52%), family history of CAD (78.02% vs. 3.8%) and aortic valve disease (62.5%) was significantly higher in group A as compared to group B.

Conclusion: Prevalence of CAD in patients with Rheumatic valvular heart disease in western population of Asian Indians with age < 50 years is 5.68%. Thus Coronary angiography should be performed in such patients only when there are associated CAD risk factors. No need of doing prophylactic angiography for those rheumatic heart disease patients who do not having any CAD risk factors in young patients age < 50 years.