Patients with atrial fibrillation and coronary artery disease – Double trouble

Michniewicz, Ewelina; Młodawska, Elżbieta; Łopatowska, Paulina; Tomaszuk‐Kazberuk, Anna; Małyszko, Jolanta

doi:10.1016/j.advms.2017.06.005

Cited by 171 publications

(155 citation statements)

References 71 publications

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“…The present study also demonstrates that AHF concurrent with new‐onset AF could develop within only a few days of the index diagnosis of scrub typhus infection (Figure A). In addition, new‐onset AF was also associated with a greater risk for developing IHD in the critically‐ill status including complicating scrub typhus infection . Coronary vasculitis also might induce direct endothelial dysfunction and vascular injury causing atherosclerotic plaque growth or rupture during the pathogenesis of IHD .…”

Section: Discussionmentioning

confidence: 99%

New‐onset atrial fibrillation predicting for complicating cardiac adverse outcome in scrub typhus infection

Jang

Kang

Kim

et al. 2019

Clinical Cardiology

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Background Scrub typhus is a well‐known infectious disorder of the Asia‐Pacific region. However, adverse cardiac outcomes are an under‐recognized complication of scrub typhus infection, and new‐onset AF has been reported to be a prognostic factor in other, more common infectious diseases. The present study investigated whether new‐onset atrial fibrillation (AF) is significantly associated with 3‐month mortality and adverse cardiac complications in scrub typhus infection. Methods We examined data from the National Health Information Database (NHID) which covers nearly the entire population of South Korea, from 2006 to 2016. In total, 233 473 patients diagnosed with scrub typhus infection were selected as study participants. New‐onset AF, acute heart failure (AHF), ischemic heart disease (IHD), and 3‐month mortality were analyzed using a generalized estimating equation model with a Poisson distribution. Results Of these, 2402 patients (1%) were diagnosed with new‐onset AF (87.2% were over 60 years of age, 43.3% were male). Those with new‐onset AF were more likely to have underlying cardiovascular disease compared to those without new‐onset AF. After being adjusted for demographic factors and comorbidities, those with new‐onset AF had a higher incidence risk of concurrent AHF (4.1‐fold) and IHD (1.9‐fold) compared with those without new‐onset AF. In particular, the 3‐month mortality was also significantly associated with new‐onset AF (1.3‐fold), concurrent AHF (2.4‐fold), and IHD (13.7‐fold). Conclusions New‐onset AF was significantly associated with 3‐month mortality and concurrent AHF and IHD. Therefore, new‐onset AF could be a poor prognostic factor for 3‐month mortality and cardiac complications in scrub typhus infection.

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Section: Discussionmentioning

confidence: 99%

New‐onset atrial fibrillation predicting for complicating cardiac adverse outcome in scrub typhus infection

Jang

Kang

Kim

et al. 2019

Clinical Cardiology

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“…In two registries EORP-AF (the EURObservational Research Programme AF Pilot General Registry) and PREFER in AF ( PREvention oF thromboembolic events—European Registry in AF), which together collected prospective data from 16 participating European countries (over 10 000 patients), approximately 20% to 35% of the patients were found to have CAD [21, 22]. In several studies, either new-onset or pre-existing AF was shown to have a negative impact on prognosis in patients with CAD treated with PCI [23-26]. …”

Section: Discussionmentioning

confidence: 99%

Patients with Atrial Fibrillation and Chronic Kidney Disease More Often Undergo Angioplasty of Left Main Coronary Artery – a 867 Patient Study

Tomaszuk‐Kazberuk

Nikas

Łopatowska

et al. 2018

Kidney Blood Press Res

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Background/Aims: Several studies have implicated atrial fibrillation (AF) as a contributing factor in chronic kidney disease (CKD) and cardiovascular events. The prevalence of coronary artery disease (CAD) in patients with AF varies substantially from 17% to 46.5%. There are only few studies concerning renal function in population with AF undergoing coronary angiography. The aim of the present study was to assess which type of AF is dominant in CKD population scheduled for coronary angiography and if it can influence patients’ outcome, the association between renal impairment and the type of coronary procedures in AF patients and the influence of renal function on in-hospital mortality. Methods: We retrospectively studied 867 patients with AF hospitalized due to coronary angiography in two year time. The cut off value of CKD was eGFR ≤ 60 ml/min./1.73m² evaluated by CKD-EPI formula. Results: A total of 867 patients with AF (44% women; mean age 72±10 years) were included in the analysis. The mean eGFR was 44±11ml/min./1.73m² in patients with CKD and 89±18 ml/min./1.73m² in patients with preserved renal function. Patients with CKD and AF were older (p< 0.001), had more often diabetes (p=0.009), heart failure (p< 0.001) and anaemia (p< 0.001). Patients with CKD and AF had more often permanent type of AF (p< 0.001). In CKD patients CHA₂DS₂VASc score was 4.3±1.5 and HAS-BLED score was 2.0±1.2 and it was significantly higher as compared to population with preserved renal function (p< 0.001, p=0.02, respectively). The use of oral anticoagulation was less frequent in CKD group (p< 0.001) although these patients had higher CHA₂DS₂VASc score. Patients with AF and CKD were more often admitted due to myocardial infarction (STEMI or NSTEMI) (p=0.02, p< 0.001, respectively) and more often underwent percutaneous coronary intervention (PCI) (p=0.01). Among coronary arteries the percutaneous coronary intervention (PCI) of left main artery was done more frequently in CKD patients (p=0.01). Among CKD population in-hospital mortality was significantly higher in patients with eGFR < 30 ml/min (p< 0.001). Conclusion: Patients with CKD had more often permanent type of AF. Percutaneous interventions of the left main coronary artery, the only elective procedures influencing patients’ prognosis, were done more frequently in CKD patients with AF. In-hospital mortality was significantly higher in patients with severe renal impairment. Despite the higher risk of ischaemic stroke in CKD group the use of oral anticoagulation therapy was significantly less frequent and the patients were deprived of the confirmed benefits of such treatment.

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“…Atrial fibrillation (AF) is the most common arrhythmia worldwide with an estimated global age adjusted prevalence of 0.5% affecting nearly 33.5 million persons . AF is associated with a multitude of comorbid conditions including coronary artery disease (CAD) which is one of the most common encountered conditions affecting nearly one‐third of the patients with AF . Acute myocardial infarction (AMI) is a well‐established risk factor for AF and one in 10 patients presenting with acute coronary syndrome (ACS) have a documented history of AF .…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of single vs dual antiplatelet therapy in patients on anticoagulation undergoing percutaneous coronary intervention: A systematic review and meta‐analysis

Atti

Turagam

Garg

et al. 2019

Cardiovasc electrophysiol

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Background Selection of an appropriate antithrombotic regimen in patients requiring oral anticoagulation (OAC) undergoing percutaneous coronary intervention (PCI) still remains a challenge. An ideal 9–2regimen should balance the risk of bleeding against ischemic benefit. Methods A comprehensive literature search for studies comparing triple antithrombotic therapy (TAT) vs double antithrombotic therapy (DAT) in patients requiring OAC undergoing PCI was performed in clinicalTrials.gov, PubMed, Web of Science, EBSCO Services, Cochrane Central Register of Controlled Trials, Google Scholar, and various scientific conference sessions from inception to May 1st, 2019. A meta‐analysis was performed using random‐effects model to calculate risk ratio (RR) and 95% confidence interval (CI). Results Fifteen studies were eligible and included 13 967 patients, of which 7349 received TAT and 6618 received DAT. Compared with DAT, TAT was associated with lower risk of myocardial infarction (RR, 0.82; 95%CI, 0.69–0.98; P = .03) and stent thrombosis (RR, 0.66; 95%CI, 0.46–0.96; P = .03). There was no difference in risk of trial defined major adverse cardiac events, all‐cause mortality, and stroke between two groups. Compared with DAT, TAT was associated with higher risk of trial defined major bleeding (RR, 1.67; 95%CI, 1.38–2.01; P < .00001), including thrombolysis in myocardial infarction major bleeding (RR, 1.81; 95%CI, 1.47–2.24; P < .00001) but no significant difference in risk of intracranial bleeding. Conclusion In patients requiring OAC undergoing PCI, TAT was associated with a lower risk of myocardial infarction but with a significantly higher risk of major bleeding when compared with DAT.

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Patients with atrial fibrillation and coronary artery disease – Double trouble

Cited by 171 publications

References 71 publications

New‐onset atrial fibrillation predicting for complicating cardiac adverse outcome in scrub typhus infection

New‐onset atrial fibrillation predicting for complicating cardiac adverse outcome in scrub typhus infection

Patients with Atrial Fibrillation and Chronic Kidney Disease More Often Undergo Angioplasty of Left Main Coronary Artery – a 867 Patient Study

Efficacy and safety of single vs dual antiplatelet therapy in patients on anticoagulation undergoing percutaneous coronary intervention: A systematic review and meta‐analysis

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