Atrial fibrillation episode status and incidence of coronary slow flow: A propensity score-matched analysis

Abstract

BackgroundPrevious studies have shown that patients with a history of atrial fibrillation (AF) have a higher risk of developing coronary slow flow (CSF). However, whether AF episode status affects the incidence of CSF has not been confirmed. This study investigated the correlation between AF episode status and the incidence of CSF.MethodsWe enrolled patients with AF who underwent coronary angiography for symptoms of myocardial ischemia between January 1, 2017, and April 30, 2022, at our institution and classified them according to whether they had an episode of AF in the perioperative period. The outcomes were defined the occurrence of CSF overall and in each of the three coronary arteries. The analysis was repeated after adjusting the baseline information by the propensity score matching method in a 1:1 ratio.Results214 patients who met the inclusion and exclusion criteria were included in the study (AF episode group: 100 patients, AF non-episode group: 114 patients). Before matching, age, left atrial size, ejection fraction, heart rate, CSF incidence, and mean corrected thrombolysis in myocardial infarction frame counts were higher in patients with intraoperative AF episodes than in patients without episodes. To prevent the dependent variable (CSF incidence) from being confounded by confounding factors, we matched the two groups for age, left atrial size, and ejection fraction. In the logistic regression analysis, the incidence of CSF was significantly higher in the intraoperative AF episode group (P = 0.010, OR = 2.327, 95% CI: 1.226–4.416) than in the non-episode group.ConclusionIn patients with AF, AF episode status is significantly correlated with an increased overall incidence of CSF.

Coronary Slow-Flow Phenomenon in Takotsubo Syndrome: The Prevalence, Clinical Determinants, and Long-Term Prognostic Impact

“…The first reports on invasive functional testing currently recommended for the assessment of microcirculation indicate that coronary microvascular dysfunction is common in patients with TTS and is even more frequent than in patients with ischemia with nonobstructive coronary arteries (INOCA) [19]. Noteworthily, in our study, we did not state a higher incidence of atrial fibrillation and more advanced stenoses in coronary arteries in the CSF group, which substantially reduces the risk of false-positive results [20]. Another possible mechanism explaining CSF is deteriorated endothelial function.…”

“…Of them, 7 patients (21.2%) had isolated CSF in LAD, whereas 26 (78.8%) revealed CSF also in the left circumflex artery (LCx) and 11 (33.3%) in the right coronary artery (RCA) (Table 3). CSF-TTS patients were characterized by higher TFC in each analyzed coronary vessel, including LAD (47.6 (40.6-54.7) vs. 25.9 (21.2-28.2) frames, p < 0.001), LCx 54 (39-72) vs. 33 (24-42) frames, p < 0.001) and RCA (27 (18-36) vs. 20 (12)(13)(14)(15)(16)(17)(18)(19)(20)(21) frames, p = 0.008) (Figure 2). Moreover, patients with CSF exhibited diminished values in myocardial perfusion.…”