Abstract
Atrial fibrillation (AF) symptoms may mimic coronary artery disease (CAD) which reflects the difficulties in qualifying AF patients for invasive diagnostics. A substantial number of coronary angiographies may be unnecessary or even put patients at risk of post-contrast acute kidney injury (PC-AKI), especially patients with chronic kidney disease (CKD). We aimed to investigate the hypothesis indicating higher prevalence of PC-AKI in patients with AF scheduled for coronary angiography. The study population comprised of 8026 patients referred for elective coronarography including 1621 with AF. In the comparison of prevalence of PC-AKI in distinguished groups we can see that kidney impairment was twice more frequent in patients with AF in both groups with CKD (CKD (+)/AF (+) 6.24% vs. CKD (+)/AF (−) 3.04%) and without CKD (CKD (−)/AF (+) 2.32% vs. CKD (−)/AF (−) 1.22%). In our study, post-contrast acute kidney disease is twice more frequent in patients with AF, especially in subgroup with chronic kidney disease scheduled for coronary angiography. Additionally, having in mind results of previous studies stating that AF is associated with non-obstructive coronary lesions on angiography, patients with AF and CKD may be unnecessarily exposed to contrast agent and possible complications.
Highlights
Atrial fibrillation (AF) is the most commonly occurring arrhythmia, while coronary artery disease (CAD) is the most common cardiovascular disease and remains the leading cause of death worldwide [1,2]
chronic kidney disease (CKD) is associated with increased frequency of post-contrast acute kidney injury (PCAKI) after coronary angiography
Separate analyses were carried out, distinguishing patients depending on presence or absence of AF and CKD
Summary
Atrial fibrillation (AF) is the most commonly occurring arrhythmia, while coronary artery disease (CAD) is the most common cardiovascular disease and remains the leading cause of death worldwide [1,2]. Both conditions share several common risk factors—. Some of the symptoms overlap, AF manifestation can mimic coronary artery disease [3,4,5,6,7] This poses difficulties in qualifying AF patients for invasive diagnostics, given that atrial fibrillation is associated with the lack of significant coronary lesions on angiography [8]. The pathophysiology of PC-AKI is not yet understood precisely, new studies exploring the subject, as well as preventive methods, should be pursued continuously [10,11]
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