Background: The association between atrial fibrillation and mitral valve disease is well known. There is limited data about association of atrial fibrillation and aortic stenosis outside of the perioperative setting.
The purpose of this study was to evaluate prevalence of aortic stenosis according to presence or absence of atrial fibrillation in patients undergoing coronary angiography.
Patients and Methods: This was a single center prospective study. One thousand consecutive patients undergoing coronary angiography were evaluated for presence of atrial fibrillation and valvular disease. SPSS statistical software was used for calculations.
Results: Of total of 1000 patients, 195 had atrial fibrillation. Patients with atrial fibrillation were more likely to be older (mean age 72.9 vs 67.0 years, p<0.0001), female (37.4% vs 28.9%, p=0.024), hypertensive (83.3% vs 73.8%, p=0.006), have heart failure (25.7% vs 11.6%, p<0.0001), and have a history of stroke (15.4% vs 8.2%, p=0.003). They were more likely to have left ventricular hypertrophy (49.2% vs 32.0%, p<0.0001), pulmonary hypertension (72.5% vs 42.9%, p<0.0001, estimated PASP 54 mm Hg vs 46 mm Hg, p<0.0001), aortic stenosis (34.3% vs 15.0%, p<0.0001), aortic regurgitation (32.0% vs 18.6%, p=0.006), mitral regurgitation (90.8% vs 77.7%) and tricuspid regurgitation (92.9% vs 78.0%, p<0.0001). There was no difference in the prevalence of diabetes, acute coronary syndrome as a reason for coronary angiography or left ventricular ejection fraction.
In the logistic regression model, which included age, gender, hypertension, diabetes, presence of obstructive CAD, calcified vessels, renal failure, anemia and atrial fibrillation, only age (p<0.0001 and atrial fibrillation (p=0.033) were independent predictors of presence of aortic stenosis.
Conclusion: patients with atrial fibrillation undergoing coronary angiography are much more likely to have valvular heart disease, especially aortic stenosis. Routine echocardiography for all patients with atrial fibrillation undergoing coronary angiography may be warranted, because its results may influence interventional strategy.
