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Clinical Profile and Angiographic Findings among Patients with Atrial Fibrillation Presenting for Selective Coronary Angiography

Elabbassi W, Chowdhury MA, BranoLiska and Hatala R

Background: Coronary artery disease is the most common form of cardiovascular disease while Atrial fibrillation is the most common sustained arrhythmia. We set out to investigate the prevalence and clinical profile of patients with atrial fibrillation who present for selective coronary angiography and whether this has an effect on the angiogram findings and the treatment options offered to them.

Methods and results: This was a retrospectively collected database of 494 patients presenting for SCAG from 01.11.2010 to 30.11.2010 and 01.04.2010 to 30.04.2010. We collected and analyzed clinical characteristics of patients, their SCAG finding and modes of treatment offered up to discharge. 24.6% of patients had AF. They tended to be older, more commonly women, current or ex-smokers; presented with symptoms of atypical chest pain and were more likely to have history of congestive heart failure or valvular heart disease. They had a longer hospital stay. Using CHADS-Vasc score, 83.6% were at moderate to high risk for CVA. At SCAG, they were more likely to have non-significant coronary artery disease, and hence were more likely to be treated conservatively.

Conclusion: AF patients presenting for SCAG constitute a unique subset of patients who despite having a higher likelihood of non-significant coronary stenosis, still are prone to suffer from poorly-understood and underappreciated myocardial ischemia.