P3622Demographic and clinical characteristics of atrial fibrillation patients suffering from an ACS without prior revascularization history

Background

The incidence of atrial fibrillation in acute coronary syndromes (ACS) ranges from 3% to 25%. The purpose of the current study was to investigate the demographic and baseline clinical characteristics, cardiovascular risk factors and comorbid conditions between patients (pts) with concomitant atrial fibrillation (AF) to those without AF in patients suffering from ACS without previous coronary artery bypass graft (CABG) and/or percutaneous coronary intervention.

Methods

The MINOCA-TR study has a cross-sectional, multicenter, observational design and was conducted with 32 interventional cardiology centers in our country. Heart rhythm at emergency admission, demographical, clinical and angiographic data was recorded for each patient. Patients with stable coronary artery disease, unstable angina pectoris and with type 4/5 myocardial infarction were excluded from study population.

Results

A total of 1626 patients (male: 70.7%, mean age: 61.4±12.5 years) were classified according to the presence of AF. The rate of AF was 3.1% in study population. This group was older (73.4 vs. 61.0 years, p<0.001) and AF was more common among females (43.1% vs. 28.7%, p=0.027). The frequency of AF was slightly higher (7.8%) in MINOCA group (p=ns).

STEMI presentation was more common in patients without AF (31.3% vs. 46.9%, p=0.028). LVEF was significantly lower in ACS patients with AF (44.1% vs. 49.4%, p=0.039). The frequency of AF was significantly higher (3.7%) in MINOCA group.

AF vs. non-AF ACS pts w/o prior revasc Parameter ACS with AF ACS without AF p value Age (years) 73.4 (±9.4) 61.0 (±12.4) <0.001 Female (%) 43.1 28.7 0.027 cTnT levels (pg/dL) median (IQR) 15.2 (96) 15.3 (428) 0.421 STEMI (%) 31.3 46.9 0.028 LVEF (%) 44.1 (±12.2) 49.4 (±10.4) 0.039 MINOCA (%) 7.8 6.6 0.743 STEMI: ST-segment elevation MI; NSTEMI: Non-ST-segment elevation myocardial infarction; LVEF: left ventricular ejection fraction; MINOCA: Myocardial Infarction with Non-Obstructive Coronary Arteries.

Conclusions

The frequency of AF was relatively lower in patients suffering from an ACS without prior revascularization history. They were older than patients without AF and were common in females. Non-ST-segment elevation myocardial infarction was significantly higher in the AF. The presence of MINOCA was similar between 2 groups.

Epicardial fat, body mass index, and triglyceride are independent contributors of serum fibroblast growth factor 21 level in obese premenopausal women

PURPOSE

The hormone fibroblast growth factor 21 (FGF-21) regulates carbohydrate and lipid homeostasis. FGF-21 represents an attractive novel therapy for obesity since administration of FGF-21 has been shown to improve metabolic abnormalities in obese animal models. We investigated FGF-21 and its relationship with epicardial fat thickness (EFT), metabolic parameters, and inflammatory markers in premenopausal obese women compared to controls with similar Systematic Coronary Risk Evaluation (SCORE) project risk profiles.

METHODS

Forty-five obese premenopausal women with body mass index (BMI) ≥30 kg/m(2) and 41 control premenopausal women with BMI <25 kg/m(2) with similar SCORE project risk profiles were included in this case-control study. EFT was evaluated by two-dimensional transthoracic echocardiography. Serum FGF-21 was measured with an ELISA kit.

RESULTS

FGF-21 and EFT were significantly higher in obese women compared to controls (p < 0.001). Multiple stepwise linear regression analysis showed that EFT, BMI, and triglycerides (TG) independently contributed to FGF-21 (R(2) = 0.757, p < 0.001). However, homeostasis model assessment of insulin resistance (HOMA-IR), visceral ectopic fat, and inflammatory markers were not found as a direct contributor to serum FGF-21 level (p > 0.05).

CONCLUSIONS

EFT, BMI, and TG may play an important role in predicting serum FGF-21 level which may be a potential therapeutic target in cardiometabolic disorders in the future.