Prevalence of atrial fibrillation dependent on coronary artery status: Insights from the<scp>LIFE‐Heart</scp>Study
Jelena Kornej, Sylvia Henger, Timm Seewöster, Andrej Teren, Ralph Burkhardt, Hölger Thiele, Joachim Thiery, Markus Scholz
Abstract
Abstract Background Coronary artery disease (CAD) is a significant risk factor for atrial fibrillation (AF). Experimental studies demonstrated that atrial ischemia induced by right coronary artery (RCA) stenosis promote AF triggers and development of electro‐anatomical substrate for AF. Aim To analyze the association between AF prevalence and coronary arteries status in the LIFE‐Heart Study. Methods This analysis included patients with available coronary catheterization data recruited between 2006 and 2014. Patients with acute myocardial infarction were excluded. CAD was defined as stenosis ≥75%, while coronary artery sclerosis (CAS) was defined as non‐critical plaque(s) <75%. Results In total, 3.458 patients (median age 63 years, 34% women) were included into analysis. AF was diagnosed in 238 (6.7%) patients. There were 681 (19.7%) patients with CAS and 1.411 (40.8%) with CAD (27.5% with single, 32.4% with double, and 40.1% with triple vessel CAD). In multivariable analysis, there was a significant association between prevalent AF and coronary artery status (OR 0.64, 95% CI 0.53‐0.78, P trend < .001). Similarly, AF risk was lower in patients with higher CAD extent (OR 0.54, 95%CI 0.35‐0.83, P trend = .005). Compared to single vessel CAD, the risk of AF was lower in double (OR 0.42, 95%CI 0.19‐0.95, P = .037) and triple CAD (OR 0.31, 95%CI 0.13‐0.71, P = .006). Finally, no association was found between AF prevalence and CAD origin among patients with single vessel CAD. Conclusion In the LIFE‐Heart Study, CAS but not CAD was associated with increased risk of AF.