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Implications of coronary artery calcium in patients with atrial fibrillation/flutter undergoing catheter ablation
Session:
Posters - B. Imaging
Speaker:
SARA ISABEL LOPES FERNANDES
Congress:
CPC 2021
Topic:
B. Imaging
Theme:
03. Imaging
Subtheme:
03.2 Computed Tomography
Session Type:
Posters
FP Number:
---
Authors:
Sara Lopes Fernandes; Ricardo Ladeiras-Lopes; Nuno Ferreira; Rita Faria; Wilson Ferreira; Mónica Carvalho; João Morais; Ricardo Fontes-Carvalho
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Introduction: </strong>Coronary artery calcium score (CACS) has emerged as a widely available and reproducible non-invasive imaging technique to refine cardiovascular risk stratification, with potential implications in terms of primary prevention interventions.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Aim: </strong>To evaluate the prevalence and clinical implications of coronary artery calcium (CAC) in patients with atrial fibrillation (AF)/flutter (AFL) undergoing catheter ablation. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Methods: </strong>Retrospective study, conducted from 2018 to 2019, including patients with AF/AFL undergoing multidetector computed tomography (MDCT) before catheter ablation for procedural planning. Baseline clinical and demographical data were collected, as well as their cardiovascular risk, based on the SCORE (Systematic Coronary Risk Evaluation) system and cardiovascular risk categories. CACS was assessed in patients without history of coronary artery disease.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Results: </strong>A total of 313 patients were included (291 with AF and 22 with AFL, mean age of 57 ± 11 years, 59% male). Excluding those over 70 years of age (n=36, 11%), most patients had low (n=46, 22%) or moderate (n=128, 60%) cardiovascular risk and 175 (63%) patients had a CHA2DS2-VASc score = 1 (male) or =2 (female). Overall, 188 patients (67%) were under anticoagulation and 97 (35%) were taking statin. CAC was present in 147 (48%) patients, with a median score of 55 (range 0 to 2564). Coronary calcium showed a multivessel distribution in 64% of patients, and it was observed most frequently in the left anterior descending artery (n=121, 82%). The left main coronary artery was affected in 47 (32%) patients. Twenty percent of patients with zero CAC were taking statins, and only 8% of patients with more than 300 CACS were prescribed high-intensity statin therapy. According to recommendations and based on their CACS and ongoing therapy, 68 (25%) patients would be candidates for statin therapy and 43 (15%) patients for changes in the current statin therapy intensity (table 1).</span></span></p> <p style="text-align:justify"><strong><span style="font-size:11.0pt">Conclusion: </span></strong><span style="font-size:11.0pt">Our findings suggest that evaluating CACS opportunistically in patients with AF/AFL undergoing MDCT before catheter ablation may be clinically valuable in the management of preventive therapies such as statins. </span></p>
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