Atrial fibrillation is more frequently associated with non-obstructive coronary lesions: The Bialystok Coronary Project

Tomaszuk‐Kazberuk, Anna; Koziński, Marek; Kuźma, Łukasz; Bujno, Elżbieta; Łopatowska, Paulina; Rogalska, Ewelina; Dobrzycki, Sławomir; Sobkowicz, Bożena; Lip, Gregory Y.H.

doi:10.20452/pamw.15635

Cited by 8 publications

(12 citation statements)

References 27 publications

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“…Overall, coronary angiography is the most effective method used to evaluate coronary vessels, especially in patients with acute coronary syndrome. In one of our previous studies, we observed that a substantial number of patients with atrial fibrillation show no significant narrowing of coronary arteries during coronarography [ 50 ]. In the present analysis, 62.49% of patients with AF presented with non-obstructive coronary lesions on angiography.…”

Section: Discussionmentioning

confidence: 99%

Atrial Fibrillation and Chronic Kidney Disease—A Risky Combination for Post-Contrast Acute Kidney Injury

Kuźma

Tomaszuk‐Kazberuk

Kurasz

et al. 2021

JCM

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Atrial fibrillation (AF) symptoms may mimic coronary artery disease (CAD) which reflects the difficulties in qualifying AF patients for invasive diagnostics. A substantial number of coronary angiographies may be unnecessary or even put patients at risk of post-contrast acute kidney injury (PC-AKI), especially patients with chronic kidney disease (CKD). We aimed to investigate the hypothesis indicating higher prevalence of PC-AKI in patients with AF scheduled for coronary angiography. The study population comprised of 8026 patients referred for elective coronarography including 1621 with AF. In the comparison of prevalence of PC-AKI in distinguished groups we can see that kidney impairment was twice more frequent in patients with AF in both groups with CKD (CKD (+)/AF (+) 6.24% vs. CKD (+)/AF (−) 3.04%) and without CKD (CKD (−)/AF (+) 2.32% vs. CKD (−)/AF (−) 1.22%). In our study, post-contrast acute kidney disease is twice more frequent in patients with AF, especially in subgroup with chronic kidney disease scheduled for coronary angiography. Additionally, having in mind results of previous studies stating that AF is associated with non-obstructive coronary lesions on angiography, patients with AF and CKD may be unnecessarily exposed to contrast agent and possible complications.

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Section: Discussionmentioning

confidence: 99%

Atrial Fibrillation and Chronic Kidney Disease—A Risky Combination for Post-Contrast Acute Kidney Injury

Kuźma

Tomaszuk‐Kazberuk

Kurasz

et al. 2021

JCM

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“…Given that the findings were based on a small population and were obtained from a retrospective single-centre study, a multi-centre prospective study should be conducted to verify these results. 5 As mentioned above, coronary angioplasty was less common in patients with AF compared to those with sinus rhythm. This raises the possibility that it may be difficult to discover patients with AF for invasive procedures.…”

Section: Future Directionsmentioning

confidence: 93%

“…4 However, other studies have reported that the independent association of the absence of AF with the localization of significant coronary lesions indicates a mixed (coronary and non-coronary) AF origin in patients with coronary artery disease (CAD). 5 Therefore, whether atrial coronary circulation plays an important role in the formation of AF is unknown. Further investigation is crucial.…”

Section: Introductionmentioning

confidence: 99%

Coronary Lesions in Patients with Atrial Fibrillation: A Retrospective Study

Chen¹,

Xia²

2021

Exploratory Research and Hypothesis in Medicine

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Background and objectives: This study was performed to determine whether atrial fibrillation (AF) is related to the precise location of a coronary artery lesion. Methods:A single-center retrospective study was conducted to compare data from clinical, laboratory, and instrumental examinations of 89 patients with AF (main group) who were admitted to the department between October 2015 and October 2019. One-hundred-and-sixty patients (comparison group) were selected according to balanced matching.Results: There were no statistically significant differences in low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TGs), troponin, or creatine kinase-myocardial band (CK-MB) between the two groups. However, the levels of homocysteine (17.0 ± 1.7 µmol/L vs. 13.7 ± 1.0 µmol/L, p = 0.001), uric acid (342.8 ± 16.7 µmol/L vs. 308.5 ± 15.1 µmol/L, p = 0.003) and creatinine (79.3 ± 4.7 µmol/L vs. 72.9 ± 3.1 µmol/L, p = 0.017) were higher in the AF group compared to the non-AF group. Moreover, the left atrium (LA) diameter (40.2 ± 1.4 mm vs. 33.5 ± 0.8 mm, p = 0.001) was larger in the AF group compared to the non-AF group. Patients with AF compared to those without AF had no significant differences in the degree or location of coronary artery lesions.Conclusions: AF in patients was not associated with specific coronary artery lesions in the current study.

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“…Many clinical risk factors promoting the development of AF were identified, such as older age, male sex, obesity, hypertension, coronary artery disease, heart failure (HF), chronic kidney disease, hyperthyroidism, diabetes mellitus (DM), chronic obstructive pulmonary disease (COPD) and valvular heart disease [ 23 , 24 , 25 ]. These disorders are responsible for the induction of unfavorable atrial structural remodeling and formation of the morphological substrate sustaining the arrhythmia.…”

Section: General Mechanisms Of Afmentioning

confidence: 99%

Mitochondrial Dysfunction in Atrial Fibrillation—Mechanisms and Pharmacological Interventions

Muszyński

Bonda

2021

JCM

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Despite the enormous progress in the treatment of atrial fibrillation, mainly with the use of invasive techniques, many questions remain unanswered regarding the pathomechanism of the arrhythmia and its prevention methods. The development of atrial fibrillation requires functional changes in the myocardium that result from disturbed ionic fluxes and altered electrophysiology of the cardiomyocyte. Electrical instability and electrical remodeling underlying the arrhythmia may result from a cellular energy deficit and oxidative stress, which are caused by mitochondrial dysfunction. The significance of mitochondrial dysfunction in the pathogenesis of atrial fibrillation remains not fully elucidated; however, it is emphasized by the reduction of atrial fibrillation burden after therapeutic interventions improving the mitochondrial welfare. This review summarizes the mechanisms of mitochondrial dysfunction related to atrial fibrillation and current pharmacological treatment options targeting mitochondria to prevent or improve the outcome of atrial fibrillation.

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Atrial fibrillation is more frequently associated with non-obstructive coronary lesions: The Bialystok Coronary Project

Cited by 8 publications

References 27 publications

Atrial Fibrillation and Chronic Kidney Disease—A Risky Combination for Post-Contrast Acute Kidney Injury

Atrial Fibrillation and Chronic Kidney Disease—A Risky Combination for Post-Contrast Acute Kidney Injury

Coronary Lesions in Patients with Atrial Fibrillation: A Retrospective Study

Mitochondrial Dysfunction in Atrial Fibrillation—Mechanisms and Pharmacological Interventions

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