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Atherosclerosis and Atrial Fibrillation: Double Trouble

Mehran Abolbashari1

  • 1Division of Cardiovascular Medicine, Texas Tech University Health Sciences Center El Paso, 4800 Alberta Avenue, El Paso, TX, 79905, USA. mehran.abolbashari@ttuhsc.edu.

Current Cardiology Reports
|January 7, 2022
PubMed

Insights

Managing cardiovascular risk in patients with atrial fibrillation (AF) and atherosclerosis requires careful antithrombotic strategies. Current evidence suggests single-drug therapy may be safer for those with coronary artery disease.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Pharmacology

Background:

  • Atrial fibrillation (AF) and atherosclerosis frequently coexist, significantly increasing cardiovascular risk.
  • Atherosclerosis burden, particularly extracranial, is a potent predictor of major adverse cardiovascular events (MACE) in AF patients.

Purpose of the Study:

  • To review major cardiovascular adverse events (MACE) in patients with concomitant atrial fibrillation (AF) and atherosclerosis.
  • To evaluate current antithrombotic approaches for managing these comorbid conditions.

Main Methods:

  • Review of recent retrospective studies and clinical trials evaluating MACE and antithrombotic therapies.
  • Analysis of data from studies focusing on patients with AF and atherosclerotic disease, including coronary artery disease (CAD).

Main Results:

  • Atherosclerosis burden is a significant marker for adverse vascular outcomes in AF.
  • The AFIRE trial indicated that rivaroxaban monotherapy is non-inferior to rivaroxaban plus aspirin in AF patients with stable CAD, offering a better safety profile.

Conclusions:

  • Antithrombotic management in AF patients with atherosclerosis is complex and not fully elucidated.
  • Further research is needed to identify specific patient subgroups who may benefit from more intensive antithrombotic strategies.
Abstract

Keywords:
AtherosclerosisAtrial FibrillationCardiovascular adverse eventsCarotid diseaseCoronary artery diseasePeripheral artery disease

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