Higher coronary artery calcium score is associated with increased risk of atrial fibrillation recurrence after catheter ablation

Autores da FMUP

• Ricardo José Araújo Ladeiras Lopes

  Autor

• António Sousa Barros

  Autor

• Francisca Almeida Saraiva

  Autor

• Hernâni Manuel Da Silva Lobo Maia Gonçalves

  Autor

• Ricardo Manuel Alves Monteiro Fontes De Carvalho

  Autor

Participantes de fora da FMUP

• Fernandes, SL
• Silva, M
• Silva, G
• Cruz, I
• Diaz, SO
• Faria, R
• Almeida, J
• Fonseca, P
• Oliveira, M
• Ferreira, N
• Primo, J

Unidades de investigação

• Cirurgia e Fisiologia

• Laboratório Associado RISE- Rede de Investigação em Saúde

  

  Investigador

  Fernando Carlos De Landér Schmitt

• Medicina da Comunidade, Informação e Decisão em Saúde

• RISE-Health

  

  Investigador

  Fernando Carlos De Landér Schmitt

Abstract

Background: Coronary artery calcium score (CACS) is associated with an increased risk of atrial fibrillation (AF) development, but scarce data are available regarding the impact on AF recurrence. This study aims to assess the impact of CACS on AF recurrence following catheter ablation.Methods: Retrospective study of patients with AF undergoing cardiac computed tomography (CCT) before ablation (2017-2019). Patients with coronary artery disease (CAD), significant valvular heart disease and previous catheter ablation were excluded. A cut-off of CACS >= 100 was used according to literature.Results: A total of 311 patients were included (median age 57 [48, 64] years, 65% men and 21% with persistent AF). More than half of the patients had a CACS > 0 (52%) and 18% a CACS >= 100. Patients with CACS >= 100 were older (64 [59, 69] vs 55 [46, 63] years, p < 0.001), had more frequently hypertension (68% vs 42%, p < 0.001) and diabetes mellitus (21% vs 10%, p = 0.020). During a median follow-up of 34 months (12-57 months), 98 patients (32%) had AF recurrence. CACS >= 100 was associated with increased risk of AF recurrence (unadjusted Cox regression: hazard ratio [HR] 2.0; 95% confidence interval [CI], 1.3-3.1, p = 0.002). After covariate adjustment, CACS >= 100 and persistent AF remained independent predictors of AF recurrence (HR, 1.7; 95% CI, 1.0-2.8, p = 0.039 and HR, 2.0; 95% CI, 1.3-3.2, p = 0.004, respectively).Conclusion: An opportunistic evaluation of CACS could be an important tool to improve clinical care considering that CACS >= 100 was independently associated with a 69% increase in the risk of AF recurrence after first catheter ablation.

Keywords

• Coronary artery calcium score; Opportunistic screening; Atrial fibrillation recurrence; Catheter ablation; Cardiac computed tomography