Association between Accessory Nipple and Coronary Artery Disease

Introduction: Accessory nipples (AN) are associated with renal anomaly, hematologic disorders, and cardiovascular disorders with Congenital heart disease, conduction system abnormalities, systemic hypertension and Mitral valve prolapse. There is no data and literature regarding association of AN with coronary artery disease (CAD) and not yet been investigated, hence the present study was undertaken. Aim and Objective: The purpose of this study was to know the association of AN with CAD. Materials And Methods: A case control study was conducted at KLE’s Dr. Prabhakar Kore Hospital & MRC, Belgaum, Karnataka, India, between January 2013 to September 2015. A total of 84 patients with AN and unstable angina, chronic stable angina and recent or prior myocardial infarction (MI) and 55 age and sex matched healthy controls were evaluated for evidence of CAD. Detailed baseline clinical, electrocardiography (ECG), echocardiography (ECHO) and coronary angiography (CAG) data were collected and compared among cases and controls. Results: A total of 139 patients were evaluated (84 cases,55 controls). Majority of the patients were male (89.29% vs 92.73%) and in the age group of 51-60 years. Cases had a higher incidence of dyslipidemia (72.62% vs 56.36%;p=0.049), cerebral vascular accidents (8.33% vs 0.00%;p=0.006), prior MI (26.19%vs0.00%;p=0.000) and prior PCI (5.95% vs 0.00;p=0.021%) compared to control group. Cases had higher incidence of abnormal ECG’s and ECHO findings compared to control group (p=0.000). CAG revealed higher incidence of coronary lesions among cases {single vessel disease(54.22%),double vessel disease(27.71%) and triple vessel disease(18.07%)}and normal coronaries among control group (p=0.000). Conclusion: The study detected a positive association between accessory nipple and coronary artery disease. So, accessory nipples should be always considered during routine physical and cardiovascular examination and require appropriate cardiac investigation for screening of associated congenital and acquired cardiac disorders.