Association of Concomitant Coronary Artery Disease With Cardiovascular Events in Patients With Atrial Fibrillation - The Fushimi AF Registry

Circ J. 2022 Jul 25;86(8):1252-1262. doi: 10.1253/circj.CJ-22-0180. Epub 2022 Jul 1.

Abstract

Background: Atrial fibrillation (AF) patients often have concomitant coronary artery disease (CAD); however, there are little data on clinical characteristics and outcomes of such patients in daily clinical practice in Japan.Methods and Results: The Fushimi AF Registry is a community-based prospective survey of AF patients in Fushimi-ku, Kyoto, Japan. Follow-up data were available for 4,464 patients, and the median follow up was 5.1 (interquartile range: 2.3-8.0) years. History of CAD was present in 647 patients (14%); of those patients, 267 (41%) had history of myocardial infarction (MI). Patients with CAD were older and had more comorbidities than those without CAD. The crude incidences (% per patient-year) of cardiovascular events were significantly higher in patients with CAD than those without CAD (cardiac death: 1.8 vs. 0.7, stroke or systemic embolism [SE]: 2.9 vs. 2.1, MI: 0.6 vs. 0.1, composite of those events: 5.1 vs. 2.8, respectively, all log-rank P<0.01). After multivariate adjustment, concomitant CAD was associated with incidence of cardiac events, and history of MI was associated with incidence of MI; however, neither history of CAD nor MI was associated with the incidence of stroke/SE.

Conclusions: In Japanese AF patients, concomitant CAD was associated with higher prevalences of major co-morbidities and higher incidences of cardiovascular events; however, history of CAD was not associated with the incidence of stroke/SE.

Keywords: Atrial fibrillation; Cardiovascular events; Coronary artery disease.

MeSH terms

  • Atrial Fibrillation* / complications
  • Atrial Fibrillation* / epidemiology
  • Coronary Artery Disease* / complications
  • Coronary Artery Disease* / epidemiology
  • Embolism* / epidemiology
  • Humans
  • Prospective Studies
  • Registries
  • Risk Factors
  • Stroke* / etiology