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Published on: February 26, 2013
Investigating the link between coronary artery calcification and atrial fibrillation: A systematic review and
Faezeh Tabesh1, Zahra Arjmand2, Zahra Teimouri-Jervekani1
1Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Insights
Coronary artery calcification (CAC) is strongly linked to atrial fibrillation (AF). This association highlights CAC as a potential factor in assessing AF risk, emphasizing the complex nature of cardiovascular health.
Area of Science:
- Cardiology
- Epidemiology
- Public Health
Background:
- Coronary artery calcification (CAC) and atrial fibrillation (AF) share common risk factors like hypertension and diabetes.
- Investigating the CAC-AF link may reveal shared mechanisms and risk profiles.
Purpose of the Study:
- To systematically review observational studies on the association between coronary artery calcification and atrial fibrillation.
- To synthesize current evidence on the relationship between CAC and AF prevalence and outcomes.
Main Methods:
- Systematic literature search of PubMed, Scopus, ISI, and Google Scholar (2000-2023).
- Inclusion of observational studies (cohort, case-control, cross-sectional) in adults reporting on CAC and AF association.
- Exclusion of studies with unavailable full text, non-English publication, or insufficient data.
Main Results:
- 14 observational studies were included, predominantly cohort and case-control.
- All studies reported a link between CAC and increased major adverse cardiovascular events (stroke, mortality) in AF patients.
- AF prevalence varied across coronary artery calcification score (CACS) categories, with a notable proportion in individuals with CACS of 0.
Conclusions:
- A robust and consistent association exists between coronary artery calcification and atrial fibrillation.
- CAC should be considered in AF risk assessment, acknowledging the multifactorial nature of AF.
- Further research may elucidate shared pathophysiological pathways between CAC and AF.
Background:
Both coronary artery calcification (CAC) and atrial fibrillation (AF) are associated with common risk factors, such as age, hypertension, diabetes, and dyslipidemia. Investigating their association may provide insights into shared pathophysiological mechanisms and overlapping risk profiles.
Methods:
A systematically search was performed covering various data bases including PubMed, Scopus, ISI, and Google Scholar from January 2000 until December 2023 for English-published articles. We focused on observational studies-cohort, case-control, and cross-sectional-that involved adult participants (aged 18 and older) and provided data on the any association between CAC and AF. We excluded studies if the full text was unavailable, the publication was not in English, there was insufficient numerical data or relative risk information.
Results:
All the included articles (n = 14), were observational studies (n = 5 case-control and n = 9 cohort). All of the included papers (100%), reported a link between CAC and higher rate of major adverse cardiovascular events such as stroke and mortality in AF patients. The overall prevalence of AF across 5 studies was estimated to be 9.00% (95% confidence intervals [CI]: 2.00, 16.00), and 60% of the AF population were male. The overall proportion of AF in individuals with a coronary artery calcification score (CACS) of 0 is relatively high at 0.48 (95% CI: 0.32, 0.64), followed by CACS (1-99) which was 0.22 (95% CI: 0.16, 0.28), CACS (100-399) which was 0.17 (95% CI: 0.07, 0.28), and CACS (≥ 400) as 0.14 (95% CI: 0.07, 0.22).
Conclusion:
It can be concluded that there is a robust and consistent association between CAC and AF. Our systematic review underscores the importance of considering CAC as a potential factor in assessing the risk of AF, while also recognizing the multifactorial nature of this relationship.
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