Abstract
Coronary artery calcium score (CACS) is associated with increased risk of atrial fibrillation (AF). However, the relationship between the burden of CACS and extra-coronary calcium and the AF is unclear. This cross-sectional study retrospectively analyzed the data of 143,529 participants (74.9% men; mean age, 41.7 ± 8.6 years) who underwent health examination including non-contrast cardiac CT and electrocardiography, from 2010 to 2018 to evaluate the association between cardiac calcium and AF. AF was diagnosed in 679 participants. The prevalence of AF was significantly increased as the CACS increased (p < 0.01). Multivariable analysis adjusted for age, sex, body mass index, hypertension, diabetes, hyperlipidemia, smoking, alcohol, and history of coronary artery disease showed a significant association between a high CACS ≥1000 and AF (OR 2.26, 95% CI 1.07–4.77, p = 0.032). In a subgroup analysis of participants with a CACS ≥100, aortic valve and thoracic aorta calcium were significantly associated with AF (OR 3.49, 95% CI 1.57–7.77, p = 0.002 and OR 2.19, 95% CI 1.14–4.21, p = 0.01, respectively). High CACS was associated with AF, and extra-coronary atherosclerosis was associated with AF in participants with a moderate to very high CACS.
Highlights
Cardiovascular calcium is generally considered as a manifestation of atherosclerosis, and coronary artery calcium (CAC) is a useful marker for subclinical atherosclerosis of the coronary artery
aortic valvevalve calcium (AVC) was defined as calcium involving the aortic valve leaflets, points of attachment, and the aortic wall immediately connected to the calcified leaflets up to the level of the sinotubular junction (STJ)
The main findings of this study were as follows: (1) severe atherosclerotic burden, represented as high calcium score (CACS) (≥1000), was significantly associated with atrial fibrillation (AF); (2) in particular, the CACS of the proximal RCA was higher in AF; (3) AVC and TAC were incrementally associated with AF in the moderate to very high CACS category (CACS ≥100)
Summary
Cardiovascular calcium is generally considered as a manifestation of atherosclerosis, and coronary artery calcium (CAC) is a useful marker for subclinical atherosclerosis of the coronary artery. Previous studies have shown that high CAC is strongly associated with the risk of future coronary artery disease (CAD) [1,2], cardiovascular events, mortality [3], and prediction of future atrial fibrillation (AF) [4,5,6,7]. Cardiac CT can be used to visualize the extent and location of coronary artery atherosclerosis as a function of the CAC burden [8,9,10]. Several studies have reported that a higher coronary artery calcium score (CACS) was associated with an. Med. 2022, 11, 371 studies have reported that a higher coronary artery calcium score (CACS) was associated with an increased of AFAmerican in both American and European populations [4,6].
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