1Universitätsklinikum Mannheim I. Medizinische Klinik Mannheim, Deutschland; 2Klinikum Nürnberg Nord Institut für klinische Chemie und Laboratoriumsmedizin und Transfusionsmedizin Nürnberg, Deutschland; 3Medizinische Hochschule Hannover Kardiologie und Angiologie Hannover, Deutschland
Objective: The study investigates a cohort of patients undergoing invasive coronary angiography (CA) and the effect of atrial fibrillation (AF) on their long-term outcomes.
Background: The ongoing demographic changes and improved treatment strategies for patients with cardiovascular disease have significantly changed the spectrum of patients undergoing CA during the past decades. The availability of data regarding the long-term outcomes of patients undergoing CA with and without AF is limited.
Methods: Consecutive patients undergoing invasive CA from 2016 to 2022 were included at one institution. Firstly, the prevalence and extent of CAD, as well as procedural-related data was assessed in patients with and without AF. Secondly, the prognosis of AF in patients undergoing CA was investigated with regard to the risk of acute myocardial infarction (AMI), revascularization and hospitalization for heart failure at 36 months of follow-up. Statistical analyses included Kaplan-Meier analyses, as well as uni- and multivariable Cox proportional regression analyses.
Results: From 2016 to 2022, 7,529 patients undergoing CA were included with a prevalence of atrial fibrillation of 26.8%. Patients with AF had a lower prevalence of CAD (63.8% vs. 72.2%; p = 0.001) and a lower prevalence of 3-vessel CAD compared to patients without AF (25.5% vs. 30.7%; p = 0.001), alongside with lower rates of percutaneous coronary intervention (PCI) (33.3% vs. 47.1%; p = 0.001). However, the risk of in-hospital all-cause mortality at 30 days did not differ between the two groups (6.3% vs. 6.6%; p = 0.626), as well as the risk of AMI at 36 months of follow-up (8.1% vs. 7.5%; p = 0.398). Even the type of AF (i.e., paroxysmal: 5.4%, persistent: 5.3%; permanent: 4.5%, new-onset 4.5%) had no prognostic impact on the risk of 30-day all-cause mortality.
Conclusion: Neither the presence, nor the type of AF affects in-hospital mortality in patients undergoing CA.