Abstract 1518: Lack Of Atrial Branches Is Associated With Higher Incidence Of Atrial Fibrilation In High Risk Acute Coronary Syndrome Patients
Backgroud: Although association between atrial fibrillation development (AF) and coronary artery disease is well established, its etiopathogenesis remains unclear. We hypothesized that angiographic atrial branches disease from the circumflex artery (abLCs), from the right coronary artery (abRCA) or from both, is associated with AF in high risk acute coronary syndromes (ACS).
Methods: The presence/absence of atrial branches in group 1 (one year consecutive ACS patients which had AF (n=56) during the hospitalization) were compared with group 2 (ACS patients without AF (n=67) chosen randomly by a computer program). Patients with dilated cardiomyopathy, mitral valvulopathy, or other AF secondary causes such pericarditis, electrolytic disturbances or inotropics administration were excluded.
Results: AF patients were significantly elderly, women and had more hypertension. There were not differences in other cardiovascular risk factors or LVEF and auricular size by echo. The absence of abLCx or abRCA or both was associated to an increased risk for AF (P=0.01, P=0.005 y P=0.002 respectively). The relative risk (95% confidence interval) for AF in absence of abLCx, abRCA or both was 1.7 (1.14–2.52), 1.77 (1.21–2.59), 2.2 (1.65–2.97) respectively. Logistic multivariate regression analysis showed that the absence of abLCx (P=0.008), abRCA (P= 0.003) or both (P=0.001), are independent risk factors for AF in ACS patients.
Conclusions: Lack of angiographic atrial branches, increase the risk for AF in ACS. The present study open new etiopathogenesis, treatment, and prognosis lines of investigation in AF patients.