Impact of Atrial Fibrillation on Coronary Artery Complexity in Patient Underwent Percutaneous Coronary Intervention

Abstract

Background: Atrial fibrillation (AF) is one of the most common arrhythmias encountered in cases with acute coronary syndrome (ACS) and in many cases, AF is relayed to coronary artery disease (CAD). The relationship is thought to be bidirectional. The results of Percutaneous Coronary Intervention are largely affected in the cases with AF.
Aim: Describe the angiographic and clinical characteristic of case with atrial fibrillation having coronary angiography with and without intervention and monitoring of in hospital course compared to patient without AF.
Subjects and Methods: The current research involved 70 cases with chronic AF, 35 cases with recent AF and 50 Sinus non-AF patients. The cases underwent detailed history taking and clinical examination. The ECG, echocardiography and laboratory data were performed to all the cases. Cardiac catheterization was through percutaneous coronary intervention (PCI). SYNTAX score was applied to determine the severity of CAD. The CHA2DS2-VA score was calculated for each case to evaluate thromboembolic risk. Patients were followed for the occurrence of cardiac events, neurological complications, bleeding and mortality. Follow up at 1 month for MACE and cardiac events.
Results: The incidence of high CHADSVA score (≥ 2) was significantly elevated in the cases with chronic AF (80%) and recent AF (85.7%) as compared to the cases with Sinus non-AF group (54%). The incidence of high syntax score was 34.3%, 40% and 18% in the chronic AF group, recent AF and sinus non-AF group respectively. The frequency of Neurological complications and Bleeding was statistically significantly elevated in the chronic AF group and recent AF group as compared to the sinus non-AF group. With follow up, non-fatal ACS, non-fatal stroke (neurological complications), bleeding and palpitations were significantly raised in the recent AF and sinus non-AF group
Conclusion: The existence of AF is related to higher complexity in the coronary arteries in the cases with CAD. Also, presence of AF was related to elevated possibility of short-term complications and higher incidence of complications with follow up.