P813 Association of clinical and echocardiographic signs with atrial fibrillation in coronary artery disease patients: a propensity score matching analysis

Abstract

Abstract Background It is known that atrial fibrillation (AF) and coronary artery disease (CAD) may be encountered coincidently in a large portion of patients. However, there are not so much data available about AF association with some clinical and echocardiographic signs in CAD patients. Purpose To find out the relationship between clinical and echocardiographic features and AF in CAD patients. Methods From local database of coronary angiography we selected patients with significant coronary stenosis (≥50% of lumen of at least one epicardial artery): 178 patients with chronic or paroxysmal AF and 331 patients without AF (the last group was selected by Propensity Score Matching with balancing by sex, age, body mass index, severity of chronic heart failure, prevalence of myocardial infarction, arterial hypertension, thyroid disease). Results Patients with AF compared to patients without AF often had higher heart rate (105 ± 32 vs 70 ± 13 beats/min, р<0.001), lower Canadian Cardiovascular Society angina classes (III-IV - 52.9% vs 66.5%, р=0.041), lower triglycerides level (1.74 ± 1.08 mmol/l vs 1.94 ± 1.17 mmol/l, р=0.019). In echocardiographic data the groups did not differ in prevalence and severity of left ventricular (LV) wall motion abnormalities. However LV dimension (26.7 ± 3.6 mm/m² vs 26.1 ± 3.3 mm/m², p = 0.028), right ventricular diameter (13.9 ± 2.0 mm/m² vs 13.3 ± 2.0 mm/m², p < 0.001), left atrial linear dimension (24.1 ± 3.2 mm/m² vs 21.6 ± 2.9 mm/m², p < 0.001), LV myocardial mass (171.0 ± 40.0 g/m² vs 154.8 ± 38.3 g/m², p < 0.001) were higher in AF patients. This group of patients more often demonstrated significant mitral regurgitation (49.1% vs 18.4%, р<0.001) and impaired LV ejection fraction (56.2% vs 39.5%, р<0.001). Coronary angiographic data showed that patients with AF more often had right coronary dominance (87.5% vs 80.4%, р=0.043), right coronary artery lesions (92.1% vs 85.8%, р=0.037), less often left main coronary artery lesions (16.3% vs 24.8%, р=0.027). Conclusions AF in CAD patients is associated with higher ventricular, left atrial dimensions, LV myocardial mass, significant mitral regurgitation and impaired LV ejection fraction and some peculiarities of clinical and coronary angiographic symptoms.