Association of Atrial Fibrillation with Coronary Lesion in Ischemic Heart Disease Patients

Abstract

to find out whether atrial fibrillation (AF) in patients with ischemic heart disease (IHD) is related to some definite localization or extentof coronary artery lesions or type of coronary circulation. We compared data of clinical, laboratory, and instrumentalexamination of 178 IHD patients from the Registry of coronary angiography of patients with AF (main group) and 331 patients(comparison group) selected according to propensity score matching with balancing by sex, age, body mass index, severity of chronic heartfailure, frequency of myocardial infarctions, detection of arterial hypertension, and thyroid diseases. The groups did not differ in termsof alcohol use, frequency of smoking, and detection of diabetes. Patients with AF compared with those without had higher mean heart rate(105±32 vs. 70±13 bpm, р<0.001), lower level of triglycerides (1.74±1.08 vs. 1.94±1.17 mmol / l, р=0.019). AF patients more rarely hadclass III-IV effort angina (52.9 % vs. 66.5 %, р=0.041). Rate of detection of left ventricular (LV) dilatation and index of LV asynergy in bothgroups were similar, but absolute dimensions and indexes of LV, left atrium, right ventricle, LV myocardial mass were higher in the AF group.Hemodynamically significant mitral regurgitation and lowering of LV contractility were more often detected in patients with AF (49.1 %vs. 18.4 %, р<0.001, and 56.2 % vs. 39.5 %, р<0.001, in main and comparison groups, respectively). Analysis of coronary angiography datashowed that patients with compared with those without AF more often had right type of coronary circulation (87.5 % vs. 80.4 %, р=0.043) aswell as lesions of the right coronary artery (92.1 % vs. 85.8 %, р=0.037), and less often lesions of left coronary artery trunk (16.3 % vs. 24.8 %,р=0.027). AF in patients with IHD is associated with right coronary artery lesions and right type of coronary circulation.