TY - JOUR
T1 - Atrial fibrillation is more frequently associated with nonobstructive coronary lesions
T2 - The Bialystok Coronary Project
AU - Tomaszuk-Kazberuk, Anna
AU - Koziński, Marek
AU - Kuzma, Łukasz
AU - Bujno, Elżbieta
AU - Lopatowska, Paulina
AU - Rogalska, Ewelina
AU - Dobrzycki, Sławomir
AU - Sobkowicz, Bożena
AU - Lip, Gregory Y H
PY - 2020/12/22
Y1 - 2020/12/22
N2 - INTRODUCTION Atrial fibrillation (AF) and chronic coronary syndrome (CCS) share common risk factors and frequently coexist. Additionally, AF symptoms may mimic CCS. OBJECTIVES The aim of the study was to investigate the hypothesis indicating absence of significant coronary lesions in patients with AF as compared with those with sinus rhythm. PATIENTS AND METHODS We conducted a single-center retrospective study including consecutive patients referred for elective coronary angiography between 2007 and 2016. RESULTS The study population included 8288 patients out of whom 1674 had AF. There were substantial differences between groups with and without AF. Patients with AF were significantly older, more often were men and had diabetes, and more frequently were diagnosed with both chronic kidney disease and heart failure. On the other hand, they had history of hyperlipidemia less often. CCS was less frequently detected in patients with AF as compared with those with sinus rhythm (37.5% vs 41.1%; P <0.001). Additionally, the latter group more often underwent subsequent coronary angioplasty (19.2% vs 22.3%; P = 0.004). Multivariable analysis identified AF as an independent factor associated with absence of significant coronary lesions (odds ratio, 1.57; 95% CI, 1.32-1.87; P <0.001). Moreover, a comparison between patients with and without angiographically significant CCS revealed a higher prevalence of AF in the latter group (18.7% vs 21.2%; P = 0.006). CONCLUSIONS In our study, AF was associated with the absence of significant coronary lesions on angiog- raphy, reflecting difficulties with qualifying patients with AF for invasive CCS diagnostic workup. Our findings suggest the need for more efficacious noninvasive diagnostic approach for patients with AF and suspected CCS.
AB - INTRODUCTION Atrial fibrillation (AF) and chronic coronary syndrome (CCS) share common risk factors and frequently coexist. Additionally, AF symptoms may mimic CCS. OBJECTIVES The aim of the study was to investigate the hypothesis indicating absence of significant coronary lesions in patients with AF as compared with those with sinus rhythm. PATIENTS AND METHODS We conducted a single-center retrospective study including consecutive patients referred for elective coronary angiography between 2007 and 2016. RESULTS The study population included 8288 patients out of whom 1674 had AF. There were substantial differences between groups with and without AF. Patients with AF were significantly older, more often were men and had diabetes, and more frequently were diagnosed with both chronic kidney disease and heart failure. On the other hand, they had history of hyperlipidemia less often. CCS was less frequently detected in patients with AF as compared with those with sinus rhythm (37.5% vs 41.1%; P <0.001). Additionally, the latter group more often underwent subsequent coronary angioplasty (19.2% vs 22.3%; P = 0.004). Multivariable analysis identified AF as an independent factor associated with absence of significant coronary lesions (odds ratio, 1.57; 95% CI, 1.32-1.87; P <0.001). Moreover, a comparison between patients with and without angiographically significant CCS revealed a higher prevalence of AF in the latter group (18.7% vs 21.2%; P = 0.006). CONCLUSIONS In our study, AF was associated with the absence of significant coronary lesions on angiog- raphy, reflecting difficulties with qualifying patients with AF for invasive CCS diagnostic workup. Our findings suggest the need for more efficacious noninvasive diagnostic approach for patients with AF and suspected CCS.
KW - Atrial fibrillation
KW - Coronary angiography
KW - Coronary artery disease
UR - http://www.scopus.com/inward/record.url?scp=85098076840&partnerID=8YFLogxK
U2 - 10.20452/pamw.15635
DO - 10.20452/pamw.15635
M3 - Journal article
C2 - 33016687
SN - 0032-3772
VL - 130
SP - 1029
EP - 1036
JO - Polskie Archiwum Medycyny Wewnetrznej
JF - Polskie Archiwum Medycyny Wewnetrznej
IS - 12
ER -