The Prognostic Implication of Coronary Artery Calcification in Patients with Atrial Fibrillation
Background: Coronary artery calcification (CAC) is a well-validated parameter reflecting the extent of subclinical atherosclerosis. Atherosclerosis manifestations are commonly presented in atrial fibrillation (AF) patients. Nevertheless, the long-term cardiovascular risks in AF patients with concomi...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Journal of Medical Sciences |
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| Online Access: | http://www.jmedscindmc.com/article.asp?issn=1011-4564;year=2023;volume=43;issue=1;spage=28;epage=36;aulast=Hsiang |
| _version_ | 1797904874178871296 |
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| author | Chih-Weim Hsiang Wen-Yu Lin Cheng-Hsiang Lo Chun-Yu Liang Tsung-Kun Lin Chun-Hsien Hsieh Jia-En Chen Wen-Cheng Liu |
| author_facet | Chih-Weim Hsiang Wen-Yu Lin Cheng-Hsiang Lo Chun-Yu Liang Tsung-Kun Lin Chun-Hsien Hsieh Jia-En Chen Wen-Cheng Liu |
| author_sort | Chih-Weim Hsiang |
| collection | DOAJ |
| description | Background: Coronary artery calcification (CAC) is a well-validated parameter reflecting the extent of subclinical atherosclerosis. Atherosclerosis manifestations are commonly presented in atrial fibrillation (AF) patients. Nevertheless, the long-term cardiovascular risks in AF patients with concomitant CAC are limited. Aim: The aim of this study is to identify the prognostic impact of CAC in patients with AF. Methods: A total of 646 eligible patients who underwent noncontrast coronary computed tomography (nCCT) from January 2012 to December 2018 were evaluated and retrospectively followed up for 2 years. The patients were assessed for cardiovascular outcomes, including nonfatal myocardial infarction, nonfatal stroke, late coronary revascularization, major adverse cardiovascular event (MACE), and total coronary and total composite events, by a multivariable Cox regression hazards model with adjusting for significant confounding factors. Results: AF patients with severe CAC (CAC score [CACS] >400 Agatston units) had significantly higher risks of composite cardiovascular outcomes, including MACEs (adjusted hazard ratio [HR]: 57.18, 95% confidence interval [CI]: 2.28–1434.41, P = 0.014), total coronary events (adjusted HR: 16.48, 95% CI: 1.21–224.15, P = 0.035), and total composite events (adjusted HR: 26.35, 95% CI: 2.45–283.69, P = 0.007), than sinus rhythm patients without CAC. Moreover, severe CAC in AF patients was a significant predictor of total composite events (adjusted HR: 59.1, 95% CI: 2.16–1616.33, P = 0.016). Conclusion: Severe CAC in AF patients may cause significantly higher cardiovascular risks, highlighting the role of nCCT in determining CACs for early risk evaluation to facilitate aggressive risk modification and thereby to prevent subsequent cardiovascular events. Further, large, prospective studies are needed to validate the impact of CAC in patients with AF. |
| first_indexed | 2024-04-10T09:55:50Z |
| format | Article |
| id | doaj.art-cc2f068b296242ae9fe3be3b5feed3f0 |
| institution | Directory Open Access Journal |
| issn | 1011-4564 |
| language | English |
| last_indexed | 2024-04-10T09:55:50Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Medical Sciences |
| spelling | doaj.art-cc2f068b296242ae9fe3be3b5feed3f02023-02-16T12:34:34ZengWolters Kluwer Medknow PublicationsJournal of Medical Sciences1011-45642023-01-01431283610.4103/jmedsci.jmedsci_335_21The Prognostic Implication of Coronary Artery Calcification in Patients with Atrial FibrillationChih-Weim HsiangWen-Yu LinCheng-Hsiang LoChun-Yu LiangTsung-Kun LinChun-Hsien HsiehJia-En ChenWen-Cheng LiuBackground: Coronary artery calcification (CAC) is a well-validated parameter reflecting the extent of subclinical atherosclerosis. Atherosclerosis manifestations are commonly presented in atrial fibrillation (AF) patients. Nevertheless, the long-term cardiovascular risks in AF patients with concomitant CAC are limited. Aim: The aim of this study is to identify the prognostic impact of CAC in patients with AF. Methods: A total of 646 eligible patients who underwent noncontrast coronary computed tomography (nCCT) from January 2012 to December 2018 were evaluated and retrospectively followed up for 2 years. The patients were assessed for cardiovascular outcomes, including nonfatal myocardial infarction, nonfatal stroke, late coronary revascularization, major adverse cardiovascular event (MACE), and total coronary and total composite events, by a multivariable Cox regression hazards model with adjusting for significant confounding factors. Results: AF patients with severe CAC (CAC score [CACS] >400 Agatston units) had significantly higher risks of composite cardiovascular outcomes, including MACEs (adjusted hazard ratio [HR]: 57.18, 95% confidence interval [CI]: 2.28–1434.41, P = 0.014), total coronary events (adjusted HR: 16.48, 95% CI: 1.21–224.15, P = 0.035), and total composite events (adjusted HR: 26.35, 95% CI: 2.45–283.69, P = 0.007), than sinus rhythm patients without CAC. Moreover, severe CAC in AF patients was a significant predictor of total composite events (adjusted HR: 59.1, 95% CI: 2.16–1616.33, P = 0.016). Conclusion: Severe CAC in AF patients may cause significantly higher cardiovascular risks, highlighting the role of nCCT in determining CACs for early risk evaluation to facilitate aggressive risk modification and thereby to prevent subsequent cardiovascular events. Further, large, prospective studies are needed to validate the impact of CAC in patients with AF.http://www.jmedscindmc.com/article.asp?issn=1011-4564;year=2023;volume=43;issue=1;spage=28;epage=36;aulast=Hsiangatrial fibrillationcoronary artery calcificationnoncontrast coronary computed tomography |
| spellingShingle | Chih-Weim Hsiang Wen-Yu Lin Cheng-Hsiang Lo Chun-Yu Liang Tsung-Kun Lin Chun-Hsien Hsieh Jia-En Chen Wen-Cheng Liu The Prognostic Implication of Coronary Artery Calcification in Patients with Atrial Fibrillation Journal of Medical Sciences atrial fibrillation coronary artery calcification noncontrast coronary computed tomography |
| title | The Prognostic Implication of Coronary Artery Calcification in Patients with Atrial Fibrillation |
| title_full | The Prognostic Implication of Coronary Artery Calcification in Patients with Atrial Fibrillation |
| title_fullStr | The Prognostic Implication of Coronary Artery Calcification in Patients with Atrial Fibrillation |
| title_full_unstemmed | The Prognostic Implication of Coronary Artery Calcification in Patients with Atrial Fibrillation |
| title_short | The Prognostic Implication of Coronary Artery Calcification in Patients with Atrial Fibrillation |
| title_sort | prognostic implication of coronary artery calcification in patients with atrial fibrillation |
| topic | atrial fibrillation coronary artery calcification noncontrast coronary computed tomography |
| url | http://www.jmedscindmc.com/article.asp?issn=1011-4564;year=2023;volume=43;issue=1;spage=28;epage=36;aulast=Hsiang |
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