Atrial fibrillation, progression of coronary atherosclerosis and myocardial infarction

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dc.contributor.authorBayturan O.
dc.contributor.authorPuri R.
dc.contributor.authorTuzcu E.M.
dc.contributor.authorShao M.
dc.contributor.authorWolski K.
dc.contributor.authorSchoenhagen P.
dc.contributor.authorKapadia S.
dc.contributor.authorNissen S.E.
dc.contributor.authorSanders P.
dc.contributor.authorNicholls S.J.
dc.date.accessioned2024-07-22T08:10:49Z
dc.date.available2024-07-22T08:10:49Z
dc.date.issued2017
dc.description.abstractBackground Despite atrial fibrillation representing an established risk factor for stroke, the association between atrial fibrillation and both progression of coronary atherosclerosis and major adverse cardiovascular events is not well characterized. We assessed the serial measures of coronary atheroma burden and cardiovascular outcomes in patients with and without atrial fibrillation. Methods Data were analyzed from nine clinical trials involving 4966 patients with coronary artery disease undergoing serial intravascular ultrasonography at 18-24 month intervals to assess changes in percent atheroma volume (PAV). Using a propensity weighted analysis, and following adjustment for baseline variables, patients with (n = 190) or without (n = 4776) atrial fibrillation were compared with regard to coronary plaque volume and major adverse cardiovascular events (death, myocardial infarction, and stroke). Results Atrial fibrillation patients demonstrated lower baseline PAV (36.0 ± 8.9 vs. 38.1 ± 8.9%, p = 0.002) and less PAV progression (-0.07 ± 0.34 vs. + 0.23 ± 0.34%, p = 0.001) compared with the non-atrial fibrillation group. Multivariable analysis revealed atrial fibrillation to independently predict both myocardial infarction [HR, 2.41 (1.74,3.35), p<0.001] 2.41 (1.74, 3.35), p < 0.00) and major adverse cardiovascular events [HR, 2.2, (1.66, 2.92), p<0.001] 2.20 (1.66, 2.92), p < 0.001]. Kaplan-Meier analysis showed that atrial fibrillation compared with non-atrial fibrillation patients had a significantly higher two-year cumulative incidence of overall major adverse cardiovascular events (4.4 vs. 2.0%, log-rank p = 0.02) and myocardial infarction (3.3 vs. 1.5%, log-rank p = 0.05). Conclusions The presence of atrial fibrillation independently associates with a heightened risk of myocardial infarction despite a lower baseline burden and progression rate of coronary atheroma. Further studies are necessary to define the pathogenesis of myocardial infarction in the setting of atrial fibrillation. © European Society of Cardiology.
dc.identifier.DOI-ID10.1177/2047487316679265
dc.identifier.issn20474873
dc.identifier.urihttp://akademikarsiv.cbu.edu.tr:4000/handle/123456789/15385
dc.language.isoEnglish
dc.publisherSAGE Publications Inc.
dc.subjectAtrial Fibrillation
dc.subjectCase-Control Studies
dc.subjectCoronary Artery Disease
dc.subjectDisease Progression
dc.subjectFemale
dc.subjectHumans
dc.subjectIncidence
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectMyocardial Infarction
dc.subjectPlaque, Atherosclerotic
dc.subjectRisk Factors
dc.subjectUltrasonography, Interventional
dc.subjectacetylsalicylic acid
dc.subjectamlodipine besylate
dc.subjectangiotensin receptor antagonist
dc.subjectatorvastatin
dc.subjectdipeptidyl carboxypeptidase
dc.subjecthydroxymethylglutaryl coenzyme A reductase inhibitor
dc.subjectrimonabant
dc.subjectrosuvastatin
dc.subjectacute coronary syndrome
dc.subjectadult
dc.subjectArticle
dc.subjectatheroma
dc.subjectatrial fibrillation
dc.subjectcardiovascular parameters
dc.subjectclinical trial (topic)
dc.subjectcontrolled clinical trial (topic)
dc.subjectcoronary artery atherosclerosis
dc.subjectdiabetes mellitus
dc.subjectdisease course
dc.subjectechography
dc.subjectfemale
dc.subjectheart infarction
dc.subjecthuman
dc.subjectimage analysis
dc.subjectintravascular ultrasonography
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectmiddle aged
dc.subjectpercent atheroma volume
dc.subjectpriority journal
dc.subjectsmoking
dc.subjectatherosclerotic plaque
dc.subjectatrial fibrillation
dc.subjectcase control study
dc.subjectcomplication
dc.subjectcoronary artery disease
dc.subjectdiagnostic imaging
dc.subjectdisease exacerbation
dc.subjectheart infarction
dc.subjectincidence
dc.subjectinterventional ultrasonography
dc.subjectpathology
dc.subjectrisk factor
dc.titleAtrial fibrillation, progression of coronary atherosclerosis and myocardial infarction
dc.typeArticle

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