title: Characteristics of coronary artery disease among patients with atrial fibrillation compared to patients with sinus rhythm.
abstract: BACKGROUND
  With a high prevalence of coronary artery disease (CAD) among patients with atrial fibrillation (AF), CAD is one of the main risk factors for AF. However, little is known about the characteristics of CAD in AF patients, especially whether a specific anatomical distribution of coronary artery stenoses might predispose an individual to AF via atrial ischemia remains speculative. To address this issue, we evaluated the potential associations between angiographic characteristics of CAD and AF.
  
  
  METHODS
  In this single-center retrospective analysis, 796 consecutive patients with confirmed CAD and AF (CAD-AF) and 785 patients with CAD and sinus rhythm (CAD-SR) were enrolled. Clinical characteristics and angiographic findings were compared between groups in stable CAD and during acute myocardial infarction (MI).
  
  
  RESULTS
  Mitral valve disease and chronic heart failure were significantly more common in CAD-AF than in CAD-SR. Clinical condition in CAD-AF was significantly more severe as indicated by New York Heart Association/World Health Organization functional class. Left ventricular ejection fraction was reduced in CAD-AF, reflecting the marked fraction of patients with ischemic cardiomyopathy. No association between anatomical characteristics of CAD and AF was found. However, CAD-AF seemed to be associated with a higher CAD severity (p = 0.06). Additionally, CAD-AF with MI showed a significantly higher number of diseased coronary vessels.
  
  
  CONCLUSIONS
  The anatomical distribution of coronary artery stenoses does not contribute to AF in CAD patients. However, AF is linked to a higher CAD severity, which might predispose individuals to AF by driving ischemic heart disease and changes in left ventricular function.
authors.affiliation: Department of Internal Medicine II, Paracelsus Medical University Salzburg, Salzburg, Austria. Electronic address: lukas.motloch@pmu.ac.at.
authors.forename: Lukas J
authors.initials: LJ
authors.lastname: Motloch
authors.affiliation: Department of Internal Medicine II, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: Sara
authors.initials: S
authors.lastname: Reda
authors.affiliation: Department of Internal Medicine II, Paracelsus Medical University Salzburg, Salzburg, Austria; Division of Electrophysiology, Department of Cardiovascular Medicine, University Hospital Muenster, Muenster, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Larbig
authors.affiliation: Department of Internal Medicine II, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: Ariane
authors.initials: A
authors.lastname: Wolff
authors.affiliation: Department of Internal Medicine II, Paracelsus Medical University Salzburg, Salzburg, Austria; Department of Ophthalmology, SALK/University Clinic, Paracelsus Medical University, Salzburg, Austria.
authors.forename: Karolina A
authors.initials: KA
authors.lastname: Motloch
authors.affiliation: Department of Internal Medicine II, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Wernly
authors.affiliation: Department of Internal Medicine II, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: Christina
authors.initials: C
authors.lastname: Granitz
authors.affiliation: Department of Internal Medicine II, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Lichtenauer
authors.affiliation: Department of Internal Medicine II, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Wolny
authors.affiliation: Department of Internal Medicine II, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: Uta C
authors.initials: UC
authors.lastname: Hoppe
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology; D023921:Coronary Stenosis / Q000150:complications* / Q000473:pathology; D005260:Female; D006325:Heart Atria / Q000503:physiopathology*; D006333:Heart Failure / Q000150:complications / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000473:pathology / Q000503:physiopathology; D009203:Myocardial Infarction / Q000150:complications / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012849:Sinoatrial Node / Q000502:physiology; D016277:Ventricular Function, Left / Q000502:physiology
keywords: atrial fibrillation; coronary artery disease; coronary artery stenoses; heart failure; myocardial infarction