Atrial fibrillation and coronary artery disease: An integrative review focusing on therapeutic implications of this relationship

Hatwal, Juniali; Batta, Akash; Verma, Samman; Sharma, Yash Paul

doi:10.4330/wjc.v15.i5.229

Cited by 45 publications

(22 citation statements)

References 78 publications

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“…Atrial fibrillation is a common complication in thyroid disease and is often associated with underlying coronary artery disease. This combination can contribute to the progression of heart failure and worsen the overall prognosis [ 11 ]. The presence of coronary artery disease in patients with thyroid disease and atrial fibrillation necessitates careful evaluation and management to mitigate the risks and potential complications, including heart failure.…”

Section: Discussionmentioning

confidence: 99%

Untreated Graves’ Disease Complicated by Thyroid Storm and High-Output Cardiac Failure: A Case Report

Patel,

Ansari,

Patibandla

et al. 2024

Cureus

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Thyroid storm is a rare yet critical complication of uncontrolled thyrotoxicosis, posing significant challenges in clinical management. We present the case of a 65-year-old African-American female with a medical history significant for untreated Graves' disease, hypertension, and diverticulosis, who presented with escalating abdominal pain, accompanied by nausea, vomiting, diarrhea, and chest discomfort. Upon admission, she exhibited atrial fibrillation with rapid ventricular response (RVR) and newly diagnosed high-output cardiac failure. Diagnosis of thyroid storm was confirmed through comprehensive laboratory assessments and clinical evaluation. Treatment with beta-blockers, anti-thyroid medications, and corticosteroids facilitated stabilization of her condition. This case report highlights the importance of early identification and intervention in thyroid storm to avert potential morbidity and mortality.

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Section: Discussionmentioning

confidence: 99%

Untreated Graves’ Disease Complicated by Thyroid Storm and High-Output Cardiac Failure: A Case Report

Patel,

Ansari,

Patibandla

et al. 2024

Cureus

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“…CHD, stroke, and AF are types of CVD [ 129 ]. Atherosclerotic plaques are the primary core of these diseases which are formed and triggered upon exposure to risk factors such as high blood pressure, high low-density lipoprotein, obesity, smoking, unhealthy diet, sedentary lifestyle, and physical inactivity.…”

Section: Discussionmentioning

confidence: 99%

Leisure-time and occupational physical activity and risk of cardiovascular disease incidence: a systematic-review and dose-response meta-analysis of prospective cohort studies

Kazemi,

Soltani,

Aune

et al. 2024

Int J Behav Nutr Phys Act

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Background and objective Physical activity has benefits for the cardiovascular system, however, what levels and types of activity provide optimal cardiovascular health is unclear. We aimed to determine the level of physical activity that has the most benefits against cardiovascular diseases (CVD). Methods PubMed, Scopus, and Web of Science were searched for prospective cohort studies on leisure-time (LTPA) or occupational physical activity (OPA) as the exposure and major types of CVD (total CVD, coronary heart disease [CHD], stroke, and atrial fibrillation [AF]) incidence as the outcome. Risk of bias of studies was evaluated using the ROBINS-I tool. Summary hazard ratios (HR) were calculated using random-effects pairwise model. Results A total of 103 studies were included in the analysis. The highest versus the lowest LTPA was associated with a lower risk of overall CVD (HR = 0.81; 95% CI: 0.77–0.86), CHD (HR = 0.83; 0.79–0.88), and stroke (HR = 0.83; 0.79–0.88), but not AF (HR = 0.98; 0.92–1.05). Linear dose-response analyses showed a 10%, 12%, 9%, and 8% risk reduction in CVD, CHD, stroke, and AF incidence, respectively, for every 20 MET-hours/week increase in LTPA. In nonlinear dose-response analyses, there were inverse associations up to 20 MET-hours/week with 19% and 20% reduction in CVD and CHD risk, and up to 25 MET-hours/week with 22% reduction in stroke, with no further risk reduction at higher LTPA levels. For AF, there was a U-shaped nonlinear association with the maximum 8% risk reduction at 10 MET-hours/week of LTPA. Higher levels of OPA were not associated with risk of CVD, CHD, stroke, or AF. Conclusions Overall, results showed an inverse dose-response relationship between LTPA and risk of CVD, CHD, stroke, and AF. Running was the most beneficial LTPA but the risk was similar among various LTPA intensities. OPA showed no benefits in total or any type of CVD.

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“…Inflammation exacerbates the electrophysiological and structural changes of the atrium through various pathways, thereby promoting the occurrence and maintenance of atrial fibrillation ( 29 ). Atherosclerosis will change the structure and function of gap junction proteins, increase the return of electrical signals and enhance the excitability of atrial tissue, further promoting the occurrence and development of atrial fibrillation ( 30 ). Endothelial dysfunction, as one of the early manifestations of atherosclerosis, is closely related to the adhesion and migration of leukocytes on the vascular endothelium, and is one of the important ways to trigger inflammation and atherosclerosis.…”

Section: Discussionmentioning

confidence: 99%

Serum albumin levels and risk of atrial fibrillation: a Mendelian randomization study

Chen,

Wang,

2024

Front. Cardiovasc. Med.

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ObjectiveAlthough several observational studies have linked serum albumin to cardiovascular disease and considered it as an important biomarker, little is known about whether increasing or maintaining serum albumin levels can effectively improve the prognosis of patients with atrial fibrillation. Therefore, this study aims to further explore the causal relationship between serum albumin and atrial fibrillation and its potential mechanism.MethodUsing data from large-scale genome-wide association studies, we conducted a two-sample Mendelian randomization (MR) analysis and a mediation MR analysis, using serum albumin as the exposure variable and atrial fibrillation as the outcome variable. We included 486 serum metabolites as potential mediating factors. To increase the robustness of the analysis, we applied five statistical methods, including inverse variance weighted, weighted median, MR-Egger, simple mode, and weighted mode. Validate the MR results using Bayesian weighted Mendelian randomization method.ResultThe results of the MR analysis indicate a significant inverse association between genetically predicted serum albumin concentration (g/L) and the risk of atrial fibrillation (Beta = −0.172, OR = 0.842, 95% CI: 0.753–0.941, p = 0.002). Further mediation MR analysis revealed that serum albumin may mediate the causal relationship with atrial fibrillation by affecting two serum metabolites, docosatrienoate and oleate/vaccenate, and the mediating effect was significant. In addition, all our instrumental variables showed no heterogeneity and level-multiplicity in the MR analysis. To verify the stability of the results, we also conducted a sensitivity analysis using the leave-one-out method, and the results further confirmed that our findings were robust and reliable. Finally, we conducted a validation using the Bayesian weighted Mendelian randomization method, which demonstrated the reliability of our causal inference results.ConclusionThis study strongly demonstrates the causal relationship between serum albumin and reduced risk of atrial fibrillation through genetic methods, and reveals the key mediating role of two serum metabolites in this relationship. These findings not only provide a new perspective for our understanding of the role of serum albumin in atrial fibrillation, but also provide new ideas for the prevention and treatment strategies of atrial fibrillation.

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Atrial fibrillation and coronary artery disease: An integrative review focusing on therapeutic implications of this relationship

Cited by 45 publications

References 78 publications

Untreated Graves’ Disease Complicated by Thyroid Storm and High-Output Cardiac Failure: A Case Report

Untreated Graves’ Disease Complicated by Thyroid Storm and High-Output Cardiac Failure: A Case Report

Leisure-time and occupational physical activity and risk of cardiovascular disease incidence: a systematic-review and dose-response meta-analysis of prospective cohort studies

Serum albumin levels and risk of atrial fibrillation: a Mendelian randomization study

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