Circulation: CT imaging confirms a-fib association with CAD

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Using multidetector CT, researchers have quantified that atrial fibrillation (a-fib) patients have a higher prevalence of obstructive coronary artery disease (CAD).

Researchers in a multi-center European study, led by Gaetano Nucifora, MD, from Leiden University Medical Center in the Netherlands, sought to evaluate with CT the prevalence of CAD among patients with paroxysmal or persistent a-fib and without a history of CAD.

They noted that previous data linking a-fib to underlying CAD were based on ECG and clinical history, rather than direct visualization of atherosclerosis. The study was published online before print Jan. 26 in Circulation: Cardiovascular Imaging.

Investigators performed CT exams on 150 a-fib patients, with slightly more than half being asymptomatic. More than three-quarters of patients had a low to intermediate pre-test likelihood of CAD. Researchers compared these patients to a control group of 148 patients without a history of a-fib.

CT imaging classified 18 percent of a-fib patients as having no CAD, whereas 41 percent showed non-obstructive CAD and the remaining 41 percent had obstructive CAD.

Among non-a-fib patients, CT found 32 percent had no CAD, while 41 percent had non-obstructive CAD and 27 percent had obstructive CAD. A logistic regression analysis showed that age, male gender and the presence of a-fib were significantly related to obstructive CAD.

Researchers concluded that a-fib could be a marker of advanced coronary atherosclerosis.