Specifics of acute coronary syndrome associated with atrial fibrillation in real world clinical practice (based on the registry of the Krasnodar Region)

Abstract

Background: Coronary heart disease is the most common cardiovascular disorder, while atrial fibrillation (AF) is the most common heart arrhythmia.Aim: To perform a comparative analysis of the coronary substrate assessed by coronary angiography in patients with acute coronary syndrome (ACS) in combination with various AF types, as well as to analyze abnormal electrocardiographic findings and blood troponin levels in patients with ACS and AF versus ACS patients with sinus rhythm.Materials and methods: We retrospectively analyzed medical files 13,244 ACS patients entered into the total ACS registry in the Krasnodar Region from 20.11.2015 to 20.11.2017. In 1204 (9%) of them ACS was associated with AF (ACS + AF group, n = 119), the remaining 12 040 (91%) patients had sinus rhythm (ASC + SR group, n = 120).Results: Compared to the ACS + SR group, the troponin levels were significantly (р ≤ 0,05) higher in the ACS + AF group. No statistically significant differences between two groups were found for localization of hemodynamically significant coronary stenoses at coronary angiography. Only 25.0% (p = 0.1689) of patients with ACS + AF without ischemic electrocardiographic changes (ST depression or elevation) had no hemodynamically significant coronary stenoses at coronary angiography.Conclusion: AF in ACS patients is an important factor in the course of the disease and is characterized by higher blood troponin levels and significantly more frequent absence of ischemia-related electrocardiographic changes, compared to the ACS patients with sinus rhythm.

Keywords

• acute coronary syndrome
• registry
• atrial fibrillation
• coronary angiography
• troponin