Prevalence of Coronary Artery Disease Assessed by Multislice Computed Tomography Coronary Angiography in Patients With Paroxysmal or Persistent Atrial Fibrillation

Abstract

Background-Although atrial fibrillation (AF) has been linked to underlying coronary artery disease (CAD), data supporting this association have been based on ECG and clinical history for the definition of CAD rather than direct visualization of atherosclerosis. Methods and Results-The prevalence of CAD among patients with paroxysmal or persistent AF and without history of CAD was evaluated using multislice computed tomography. Multislice computed tomography was performed in 150 patients with AF (61Ϯ11 years, 67% males, 58% asymptomatic) with predominantly low (59%) or intermediate (25%) pretest likelihood of CAD. CAD was classified as obstructive (Ն50% luminal narrowing) or not. A population of 148 patients without history of AF, similar to the AF group as to age, gender, symptomatic status, and pretest likelihood, served as a control group. Logistic regression analysis was applied to evaluate the relationship between demographic and clinical data and the presence of obstructive CAD. On the basis of multislice computed tomography, 18% of patients with AF were classified as having no CAD, whereas 41% showed nonobstructive CAD and the remaining 41% had obstructive CAD. Among patients without AF, 32% were classified as having no CAD, whereas 41% showed nonobstructive CAD and 27% had obstructive CAD (Pϭ0.010 compared with patients with AF). At logistic regression analysis, age, male gender, and the presence of AF were significantly related to obstructive CAD. Conclusion-A higher prevalence of obstructive CAD was observed among patients with AF, confirming the hypothesis that AF could be a marker of advanced coronary atherosclerosis. (Circ Cardiovasc Imaging. 2009;2:100-106.)

Evaluation of the Diamondback 360 Coronary Orbital Atherectomy System for treatingde novo, severely calcified lesions

“…In the literature, calcification scoring via CT is often uniquely described but can usually be found in terms of severity, typically ranging from none or mild to severe or >130 Hu for CT angiography [8][9][10][11][12][13][14][15][16][17][18]. Methods for interpreting the score, however, have not been standardized.…”

Risk factors associated with ischemic heart disease occurence in acute ischemic stroke patients

“…In previous studies [26][27][28][29] atrial fibrillation and carotid stenosis 30 showed positive correlation to IHD presence in IS patients. However study design and primary goals were different to this study.…”

Looking for Coronary Disease in Patients With Atrial Fibrillation

“…Results from several representative studies are listed in Table 1. [1][2][3][4][5][6][7][8] The prevalence ranges from 22% to 49%, with the lowest prevalence observed in the study of Tsigkas et al, published in this issue of the Canadian Journal of Cardiology. 8 The clinical factors predictive of CAD in patients with AF tend to be the same as in patients without AF, with older age, male sex, and smoking predominating.…”

“…8 The clinical factors predictive of CAD in patients with AF tend to be the same as in patients without AF, with older age, male sex, and smoking predominating. [3][4][5]7 …”

“…7. AF is a strong predictor of all-cause mortality, independent of the presence and severity of CAD 14-16 8.…”