Association of atrial fibrillation with severity of coronary artery disease: the Emory Cardiovascular Biobank (EmCAB) Open Access
Li, Linzi (Spring 2021)
Abstract
Background
Existing literatures suggest that atrial fibrillation (AF) can lead to coronary artery disease (CAD). However, little information is known regarding the association between AF and CAD severity.
Methods
We conducted cross-sectional and prospective cohort analysis of 7737 participants in the Emory Cardiovascular Biobank (EmCAB). At enrollment, data on AF history and four CAD severity measurements were collected: presence of 70% coronary stenosis, presence of 50% coronary stenosis, number of vessels with 50% coronary stenosis and the Gensini score. Different models were used to examine the association between each measurement and AF history. During follow-up, occurrence of incident MI, fatal MI and all-cause death were obtained as primary endpoints. We used Cox regression model to examine AF and each endpoint. Sex-specific and race-specific estimates were also calculated in both analyses.
Results
At baseline, no association was found between AF and presence of 50% and 70% stenosis, and numbers of vessels with 50% stenosis. AF was associated with 4.92 (95% CI -8.91, -0.93) points lower Gensini score in the crude model, but not in the adjusted model (beta coefficient: -4.66, 95% CI -9.71, 0.39). In the Longitudinal analysis, there was no evidence supporting association between AF and nonfatal MI, fatal MI and any MI. The risk of all-cause mortality among AF patients was 1.66 times (95% CI 0.91, 1.49) that among non-AF patients in the crude model. However, the association no longer existed after adjusting for covariates. In the dataset with imputed covariates, AF was associated with all-cause mortality in both crude and adjusted models (adjusted HR 1.26, 95% CI 1.03, 1.53). Similar results were found in strata of sex and race.
Conclusion
In the EmCAB, AF was associated with all-cause mortality but not with CAD severity.
Table of Contents
Table of contents
Introduction…………………..…………………..…………………..…………………..…………………..…………………..……1
Methods…………………..…………………..…………………..…………………..…………………..…………………..…………2
Study population…………………..…………………..…………………..…………………..…………………..….…….........2
Study design…………………..…………………..…………………..…………………..…………………..………………........2
Determination of AF and characterization of CAD severity…………..…………………..…………….......................3
Covariates…………..…………………..………………………..…………………..………………………..………………....... 3
Statistical analysis…………..…………………..………………………..…………………..……………………………..........3
Results…………..…………………..………………………..…………………..………………………..…………………..…….… 5
AF and CAD severity at baseline…………..…………………..………………………..…………………..……….............. 5
Relationship between AF and MI and all-cause mortality…………..…………………..………………......................6
Sensitivity analysis…………..…………………..………………………..…………………..………………………..…. .........6
Discussion…………..…………………..………………………..…………………..………………………..…………………..……7
Disclosures…………..…………………..………………………..…………………..………………………..…………………..….10
Funding…………..…………………..………………………..…………………..………………………..…………………..........10
Tables…………..…………………..………………………..…………………..………………………..…………………..………..11
Supplemental tables…………..…………………..………………………..…………………..………………………..……….....15
References …………..…………………..………………………..…………………..………………………..…………………..….16
About this Master's Thesis
| School | |
|---|---|
| Department | |
| Subfield / Discipline | |
| Degree | |
| Submission | |
| Language |
|
| Research Field | |
| Keyword | |
| Committee Chair / Thesis Advisor |
Primary PDF
| Thumbnail | Title | Date Uploaded | Actions |
|---|---|---|---|
|
|
Association of atrial fibrillation with severity of coronary artery disease: the Emory Cardiovascular Biobank (EmCAB) () | 2021-04-30 14:39:25 -0400 |
|
Supplemental Files
| Thumbnail | Title | Date Uploaded | Actions |
|---|