Impact of coronary artery calcium score screening on cardiovascular risk stratification of patients with atrial fibrillation undergoing ablation

Autores da FMUP

• Ricardo Manuel Alves Monteiro Fontes De Carvalho

  Autor

• Ricardo José Araújo Ladeiras Lopes

  Autor

Participantes de fora da FMUP

• Fernandes, S
• Cruz, I
• Faria, R
• Almeida, J
• Fonseca, P
• Ferreira, N
• Primo, JJ

Unidades de investigação

• Cirurgia e Fisiologia

• Laboratório Associado RISE- Rede de Investigação em Saúde

  

  Investigador

  Fernando Carlos De Landér Schmitt

• RISE-Health

  

  Investigador

  Fernando Carlos De Landér Schmitt

Abstract

Introduction: There is a well-established association between atrial fibrillation (AF) and coronary artery disease. Coronary artery calcium score (CACS) is a helpful tool to refine cardiovascular (CV) risk stratification and inform on the best strategies for primary CV prevention. This study aims to evaluate the impact of opportunistic screening with CACS on risk stratification and decision of preventive therapies, in patients with AF. Methods: Cross-sectional study including patients with AF or atrial flutter undergoing cardiac computed tomography for ablation procedure planning, from 2017 to 2019. Baseline clinical and demographical data were collected. CACS was assessed in patients without coronary artery disease using the Agatston method. Results: A total of 474 patients were included (93% with AF, mean age of 58 & PLUSMN; 10 years, 62% male). CACS >0 was present in 254 (54%) patients. According to CACS and the Society of Cardiovascular Computed Tomography recommendations, 25% of the patients would be candidates for statin therapy and 17% would be candidates for changes in the current statin intensity; in 11 patients (8%) acetylsalicylic acid would be recommended. Discussion/Conclusion: In our study, more than half of the patients undergoing cardiac computed tomography before AF catheter ablation had CACS above zero. Our findings suggest that an opportunistic evaluation of CACS at the time of ablation can be an important tool to improve CV risk stratification, with important clinical and therapeutic implications.

Keywords

• PROGNOSTIC VALUE; DISEASE; PREVALENCE; ADULTS