Coronary artery diseaseEffect of Atrial Fibrillation on Outcome in Patients With Known or Suspected Coronary Artery Disease Referred for Exercise Stress Testing
Section snippets
Methods
This was a retrospective analysis of a prospectively collected database. From March 1995 to March 2008, we evaluated 17,100 consecutive patients with known or suspected CAD aged ≥50 years who were referred for first treadmill stress testing at our institution. Of them, 11,911 underwent exercise electrocardiography and 5,189 underwent exercise echocardiography. Demographic, clinical, and stress test data were entered in a dedicated database at the time of the tests. All patients gave informed
Results
Of the 17,100 patients, 619 (3.6%) presented with AF at the time of the exercise stress tests. Baseline characteristics of the 17,100 patients are listed in Table 1, and exercise data are listed in Table 2.
A total of 15,324 patients had interpretable rest electrocardiograms. Of them, 2,516 patients (16.4%) developed significant exercise-induced ST-segment abnormalities, and the latter occurred less frequently in patients with AF (12.0% vs 16.5% in patients without AF, p = 0.028). In contrast,
Discussion
This study is the first to assess the association of AF with myocardial ischemia, CAD, and outcomes in patients with known or suspected CAD referred for exercise stress testing. Despite being associated with an apparently lower likelihood of myocardial ischemia, as assessed by exercise electrocardiography and exercise echocardiography, AF was an independent predictor of all-cause mortality in these patients. However, we did not observe a significant, independent association with nonfatal
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