Marco Proietti1, Camilla Calvieri1, Lorenzo Malatino2, Santo Signorelli3, Gino Roberto Corazza4, Francesco Perticone5, Anna Rita Vestri6, Lorenzo Loffredo1, Giovanni Davì7, Francesco Violi1, Stefania Basili8. 1. I Clinica Medica, Sapienza-University of Rome, Italy. 2. Clinica Medica e Centro Ipertensione, Ospedale Cannizzaro, University of Catania, Catania, Italy. 3. Dipartimento di Scienze Mediche e Pediatriche, University of Catania, UOSD di Angiologia Medica, Ospedale Garibaldi, Catania, Italy. 4. First Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy. 5. Department of Medical and Surgical Sciences, University of Magna-Graecia of Catanzaro, Catanzaro, Italy. 6. Department of Public Health and Infectious Disease, Sapienza-University of Rome, Rome, Italy. 7. Department of Internal Medicine, University of Chieti, Chieti, Italy. 8. I Clinica Medica, Sapienza-University of Rome, Italy. Electronic address: stefania.basili@uniroma1.it.
Abstract
OBJECTIVE: Carotid intima-media thickness (cIMT) is a surrogate marker of subclinical atherosclerosis and it is able to predict both coronary and cerebral vascular events. No data exist on the association between cIMT and non valvular atrial fibrillation (NVAF) type. We conduct this study with the aim to analyze the association between abnormal cIMT and NVAF type. METHODS: A cross-sectional study of the "Atrial fibrillation Registry for Ankle-brachial index Prevalence Assessment-Collaborative Italian Study (ARAPACIS)" has been performed. Among 2027 patients enrolled in the ARAPACIS, 673 patients, who underwent carotid ultrasound examination to assess cIMT, were included in the study. RESULTS: Among the entire population, 478 patients (71%) had cIMT > 0.90 mm. Patients with an abnormal cIMT (>0.90 mm) were significantly older and more likely hypertensive, diabetic and with a previous history of stroke than those with normal cIMT (≤0.90 mm). These patients had more permanent/persistent NVAF and CHA2DS2-VASc score ≥ 2 (p < 0.0001) compared to those with cIMT <0.90 mm. Excluding all patients affected by previous cardiovascular disease, logistic regression analysis showed that independent predictors of abnormal cIMT were: age class 65-74 yrs. (p < 0.001), age class ≥75 yrs. (p < 0.001), arterial hypertension (p < 0.001), calcium-channel blockers use (p < 0.001) and persistent/permanent NVAF (p = 0.001). CONCLUSION: Our findings show a high prevalence of abnormal cIMT in NVAF patients, reinforcing the concept that NVAF and systemic atherosclerosis are closely associated. Abnormal cIMT was particularly evident in persistent/permanent NVAF suggesting a more elevated atherosclerotic burden in patients with long-standing NVAF. TRIAL REGISTRATION: http://clinicaltrials.gov/ct2/show/NCT01161251.
OBJECTIVE: Carotid intima-media thickness (cIMT) is a surrogate marker of subclinical atherosclerosis and it is able to predict both coronary and cerebral vascular events. No data exist on the association between cIMT and non valvular atrial fibrillation (NVAF) type. We conduct this study with the aim to analyze the association between abnormal cIMT and NVAF type. METHODS: A cross-sectional study of the "Atrial fibrillation Registry for Ankle-brachial index Prevalence Assessment-Collaborative Italian Study (ARAPACIS)" has been performed. Among 2027 patients enrolled in the ARAPACIS, 673 patients, who underwent carotid ultrasound examination to assess cIMT, were included in the study. RESULTS: Among the entire population, 478 patients (71%) had cIMT > 0.90 mm. Patients with an abnormal cIMT (>0.90 mm) were significantly older and more likely hypertensive, diabetic and with a previous history of stroke than those with normal cIMT (≤0.90 mm). These patients had more permanent/persistent NVAF and CHA2DS2-VASc score ≥ 2 (p < 0.0001) compared to those with cIMT <0.90 mm. Excluding all patients affected by previous cardiovascular disease, logistic regression analysis showed that independent predictors of abnormal cIMT were: age class 65-74 yrs. (p < 0.001), age class ≥75 yrs. (p < 0.001), arterial hypertension (p < 0.001), calcium-channel blockers use (p < 0.001) and persistent/permanent NVAF (p = 0.001). CONCLUSION: Our findings show a high prevalence of abnormal cIMT in NVAFpatients, reinforcing the concept that NVAF and systemic atherosclerosis are closely associated. Abnormal cIMT was particularly evident in persistent/permanent NVAF suggesting a more elevated atherosclerotic burden in patients with long-standing NVAF. TRIAL REGISTRATION: http://clinicaltrials.gov/ct2/show/NCT01161251.
Authors: Giuseppe Boriani; Marco Vitolo; Igor Diemberger; Marco Proietti; Anna Chiara Valenti; Vincenzo Livio Malavasi; Gregory Y H Lip Journal: Cardiovasc Res Date: 2021-06-16 Impact factor: 13.081
Authors: Lin Y Chen; Maarten J G Leening; Faye L Norby; Nicholas S Roetker; Albert Hofman; Oscar H Franco; Wei Pan; Joseph F Polak; Jacqueline C M Witteman; Richard A Kronmal; Aaron R Folsom; Saman Nazarian; Bruno H Stricker; Susan R Heckbert; Alvaro Alonso Journal: J Am Heart Assoc Date: 2016-05-20 Impact factor: 5.501