Abstract 18727: Atrial Fibrillation is an Independent Predictor of Higher Coronary Atherosclerosis Burden
Introduction: Atrial fibrillation (AFIB) and coronary artery disease (CAD) share common risk factors. It’s unknown if AFIB is an independent predictor of subclinical CAD.
Objectives: Evaluate the association of AFIB with subclinical CAD as determined by coronary artery calcium scoring (CACs)
Method: 430 consecutive AFIB patients without angina, known CAD, systolic heart failure, valvular heart disease and cardiomyopathy underwent CACs with Multi-detectors CT. Results were compared to 1) Age, gender and race predicted CACs using MESA (Multi-ethnic study of atherosclerosis) calculator 2) Age and gender matched cohort of 430 patients presented with chest pain and suspected CAD.
Results: The mean age of the population was 63±10, 65% male and 16% diabetics, 63% hypertensive. Prevalence of CAD (CACs > 0) was 76 % of patients with AFIB and significantly higher than predicted by MESA calculator (Figure).Among AFIB patients, 64% had higher CACs than MESA predicted CACs at 50th percentile (P <0.001) while 13 % had higher CACs than MESA predicted CACs at 90th percentile (P =0.05). In 320 AFIB patients with CACS > 0, estimated arterial age was higher than the actual biological age. (68.8± 12 Vs.64.1±8.9, mean difference of 4.7 ±13 years, median of 5. P < 0.001).
Compared to the chest pain cohort, prevalence of CAD (CACs > 0) and severe CACS (>400) in patients with AFIB was significantly higher (Figure).Multivariable -analysis adjusted to Framingham 10 years risk showed that the presence of AFIB is independently associated with the presence of CACs (OR 1.81; 95% CI 1.34-2.44; P<0.001) and severe calcification (OR 2.32; 95%CI 1.43-3.74; p0.001)
Conclusion: Presence of AFIB without other known cardiac disease appears to have higher prevalence and more advanced CAD when compared to both epidemiological data and symptomatic patients with suspected CAD.
- © 2013 by American Heart Association, Inc.