Relationship between obstructive coronary artery disease and abnormal stress testing in patients with paroxysmal or persistent atrial fibrillation

Gaetano Nucifora, Joanne D. Schuijf, Jacob M. Van Werkhoven, Serge A. Trines, Sami Kajander, Laurens F. Tops, Olli Turta, J. Wouter Jukema, Joop H.M. Schreur, Mark W. Heijenbrok, Oliver Gaemperli, Philipp A. Kaufmann, Juhani Knuuti, Ernst E. Van Der Wall, Martin J. Schalij, Jeroen J. Bax

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Atrial fibrillation (AF) has been linked to the presence of underlying coronary artery disease (CAD). However, whether the higher burden of CAD observed in AF patients translates into higher burden of myocardial ischemia is unknown. In 87 patients (71% male, mean age 61 ± 10 years) with paroxysmal or persistent AF and without history of CAD, MSCT coronary angiography and stress testing (exercise ECG test or myocardial perfusion imaging) were performed. CAD was classified as obstructive (≥50% luminal narrowing) or not. Stress tests were classified as normal or abnormal. A population of 122 patients without history of AF, similar to the AF group as to age, gender, symptomatic status and pre-test likelihood, served as a control group. Based on MSCT, 17% of AF patients were classified as having no CAD, whereas 43% showed non-obstructive CAD and the remaining 40% had obstructive CAD. A positive stress test was observed in 49% of AF patients with obstructive CAD. Among non-AF patients, 34% were classified as having no CAD, while 41% showed nonobstructive CAD and 25% had obstructive CAD (P = 0.013 compared to AF patients). A positive stress test was observed in 48% of non-AF patients with obstructive CAD. In conclusion, the higher burden of CAD observed in AF patients is not associated to higher burden of myocardial ischemia.

LanguageEnglish
Pages777-785
Number of pages9
JournalInternational Journal of Cardiovascular Imaging
Volume27
Issue number6
DOIs
Publication statusPublished - 1 Jul 2011

Keywords

  • Atrial fibrillation
  • Coronary artery disease
  • Multi-slice computed tomography
  • Prevalence
  • Risk stratification
  • Stress testing

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Nucifora, Gaetano ; Schuijf, Joanne D. ; Van Werkhoven, Jacob M. ; Trines, Serge A. ; Kajander, Sami ; Tops, Laurens F. ; Turta, Olli ; Jukema, J. Wouter ; Schreur, Joop H.M. ; Heijenbrok, Mark W. ; Gaemperli, Oliver ; Kaufmann, Philipp A. ; Knuuti, Juhani ; Van Der Wall, Ernst E. ; Schalij, Martin J. ; Bax, Jeroen J. / Relationship between obstructive coronary artery disease and abnormal stress testing in patients with paroxysmal or persistent atrial fibrillation. In: International Journal of Cardiovascular Imaging. 2011 ; Vol. 27, No. 6. pp. 777-785.
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abstract = "Atrial fibrillation (AF) has been linked to the presence of underlying coronary artery disease (CAD). However, whether the higher burden of CAD observed in AF patients translates into higher burden of myocardial ischemia is unknown. In 87 patients (71{\%} male, mean age 61 ± 10 years) with paroxysmal or persistent AF and without history of CAD, MSCT coronary angiography and stress testing (exercise ECG test or myocardial perfusion imaging) were performed. CAD was classified as obstructive (≥50{\%} luminal narrowing) or not. Stress tests were classified as normal or abnormal. A population of 122 patients without history of AF, similar to the AF group as to age, gender, symptomatic status and pre-test likelihood, served as a control group. Based on MSCT, 17{\%} of AF patients were classified as having no CAD, whereas 43{\%} showed non-obstructive CAD and the remaining 40{\%} had obstructive CAD. A positive stress test was observed in 49{\%} of AF patients with obstructive CAD. Among non-AF patients, 34{\%} were classified as having no CAD, while 41{\%} showed nonobstructive CAD and 25{\%} had obstructive CAD (P = 0.013 compared to AF patients). A positive stress test was observed in 48{\%} of non-AF patients with obstructive CAD. In conclusion, the higher burden of CAD observed in AF patients is not associated to higher burden of myocardial ischemia.",
keywords = "Atrial fibrillation, Coronary artery disease, Multi-slice computed tomography, Prevalence, Risk stratification, Stress testing",
author = "Gaetano Nucifora and Schuijf, {Joanne D.} and {Van Werkhoven}, {Jacob M.} and Trines, {Serge A.} and Sami Kajander and Tops, {Laurens F.} and Olli Turta and Jukema, {J. Wouter} and Schreur, {Joop H.M.} and Heijenbrok, {Mark W.} and Oliver Gaemperli and Kaufmann, {Philipp A.} and Juhani Knuuti and {Van Der Wall}, {Ernst E.} and Schalij, {Martin J.} and Bax, {Jeroen J.}",
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Nucifora, G, Schuijf, JD, Van Werkhoven, JM, Trines, SA, Kajander, S, Tops, LF, Turta, O, Jukema, JW, Schreur, JHM, Heijenbrok, MW, Gaemperli, O, Kaufmann, PA, Knuuti, J, Van Der Wall, EE, Schalij, MJ & Bax, JJ 2011, 'Relationship between obstructive coronary artery disease and abnormal stress testing in patients with paroxysmal or persistent atrial fibrillation', International Journal of Cardiovascular Imaging, vol. 27, no. 6, pp. 777-785. https://doi.org/10.1007/s10554-010-9725-x

Relationship between obstructive coronary artery disease and abnormal stress testing in patients with paroxysmal or persistent atrial fibrillation. / Nucifora, Gaetano; Schuijf, Joanne D.; Van Werkhoven, Jacob M.; Trines, Serge A.; Kajander, Sami; Tops, Laurens F.; Turta, Olli; Jukema, J. Wouter; Schreur, Joop H.M.; Heijenbrok, Mark W.; Gaemperli, Oliver; Kaufmann, Philipp A.; Knuuti, Juhani; Van Der Wall, Ernst E.; Schalij, Martin J.; Bax, Jeroen J.

In: International Journal of Cardiovascular Imaging, Vol. 27, No. 6, 01.07.2011, p. 777-785.

Research output: Contribution to journalArticle

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AU - Schuijf, Joanne D.

AU - Van Werkhoven, Jacob M.

AU - Trines, Serge A.

AU - Kajander, Sami

AU - Tops, Laurens F.

AU - Turta, Olli

AU - Jukema, J. Wouter

AU - Schreur, Joop H.M.

AU - Heijenbrok, Mark W.

AU - Gaemperli, Oliver

AU - Kaufmann, Philipp A.

AU - Knuuti, Juhani

AU - Van Der Wall, Ernst E.

AU - Schalij, Martin J.

AU - Bax, Jeroen J.

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AB - Atrial fibrillation (AF) has been linked to the presence of underlying coronary artery disease (CAD). However, whether the higher burden of CAD observed in AF patients translates into higher burden of myocardial ischemia is unknown. In 87 patients (71% male, mean age 61 ± 10 years) with paroxysmal or persistent AF and without history of CAD, MSCT coronary angiography and stress testing (exercise ECG test or myocardial perfusion imaging) were performed. CAD was classified as obstructive (≥50% luminal narrowing) or not. Stress tests were classified as normal or abnormal. A population of 122 patients without history of AF, similar to the AF group as to age, gender, symptomatic status and pre-test likelihood, served as a control group. Based on MSCT, 17% of AF patients were classified as having no CAD, whereas 43% showed non-obstructive CAD and the remaining 40% had obstructive CAD. A positive stress test was observed in 49% of AF patients with obstructive CAD. Among non-AF patients, 34% were classified as having no CAD, while 41% showed nonobstructive CAD and 25% had obstructive CAD (P = 0.013 compared to AF patients). A positive stress test was observed in 48% of non-AF patients with obstructive CAD. In conclusion, the higher burden of CAD observed in AF patients is not associated to higher burden of myocardial ischemia.

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KW - Coronary artery disease

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KW - Risk stratification

KW - Stress testing

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