Characteristics of incident coronary artery disease in patients undergoing atrial fibrillation ablation
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Background Few reports have provided detailed characteristics of incident coronary artery disease and its risk factors in patients undergoing ablation for atrial fibrillation.. Methods Patients undergoing ablation for atrial fibrillation with no documented coronary artery disease were retrospectively studied at our institution. Patients were divided into two groups: those in whom significant stenosis was detected incidentally on coronary angiography performed at the same time as ablation and those in whom it was not, and the detection rate and its predictors were examined. Results Of the 550 patients, 30 patients showed incidental coronary artery disease (CAD) (detection rate: 3.6%). We compared clinical data between these 30 patients (ABL-CAD group) and the 520 patients (ABL-non-CAD group) who displayed no significant stenosis on coronary angiography. In multivariate analysis, age, hemoglobinA1c (HbA1c) and high-density lipoprotein cholesterol (HDL-chol.) were predictive factors (odds ratio: 1.08, 2.43, 1.58, 95% CI: 1.01–1.14, 1.53–3.86, 0.92–0.99, P value: 0.014, 0.004, 0.024, respectively) for identification of CAD. Multivariate analysis based on cut-off values from receiver operating characteristic analysis identified age, HbA1c ≥ 6.1%, HDL ≤ 49 mg/dL as predictors (odds ratios: 1.06, 4.04, 3.07; 95% confidence intervals [CIs]: 1.00–1.12, 1.58–10.3, 1.18–8.01; P = 0.04, P < 0.01, P = 0.021, respectively). Area under the curve was significantly greater for age plus HbA1c ≥ 6.1% plus HDL ≤ 49 mg/dL (0.810) than for age alone (0.672; P = 0.005). Conclusion Patients undergoing ablation for atrial fibrillation appear likely to have CAD if HbA1c is ≥ 6.1% and HDL-chol is ≤ 49 mg/dL.
