DETECTION OF LATENT CORONARY ARTERY DISEASE IN PATIENTS WITH ATRIAL FIBRILLATION AND HIGH CARDIOVASCULAR RISK: A CLINICAL ASPECT

Goal. To identify the frequency and features of coronary artery disease in patients with AF without an established diagnosis of coronary artery disease who underwent coronary angiography for the first time. Materials and methods. The study included 31 patients with AF who were hospitalized in the cardiology department. All participants had not previously undergone invasive coronary artery imaging and had no history of coronary artery disease. All patients underwent coronary angiography. In addition, a Framingham cardiovascular risk assessment was performed, clinical and demographic data were collected, including age, the presence of risk factors (hypertension, hypercholesterolemia, smoking, diabetes mellitus), symptoms corresponding to angina pectoris, and concomitant pathology. Results. Coronary artery disease was detected in 11 patients (35.5%) out of 31. At the same time, 8 patients (25.8%) required myocardial revascularization — percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). The presence of coronary heart disease was associated with older age, hypercholesterolemia, a history of angina pectoris, and the presence of risk factors such as smoking. The data obtained indicate that in patients with AF and high cardiovascular risk, the presence of coronary artery disease may be underestimated in the absence of typical symptoms. Conclusions. Conducting coronary angiography in patients with atrial fibrillation, especially in the presence of high cardiovascular risk, seems clinically justified. This allows timely detection of latent coronary heart disease and necessary treatment, including revascularization, thereby reducing the risk of adverse cardiovascular events and improving the prognosis of this category of patients.