INTRODUCTION There is a well-established association between atrial fibrillation (AF) and coronary artery disease. Coronary artery calcium score (CACS) is a helpful tool to refine cardiovascular (CV) risk stratification and inform on the best strategies for primary CV prevention. This study aims to evaluate the impact of opportunistic screening with CACS on risk stratification and decision of preventive therapies, in patients with AF. METHODS Cross-sectional study including patients with AF or atrial flutter undergoing cardiac computed tomography for ablation procedure planning, from 2017 to 2019. Baseline clinical and demographical data were collected. CACS was assessed in patients without coronary artery disease using the Agatston method. RESULTS A total of 474 patients were included (93% with AF, mean age of 58 ± 10 years, 62% male). CACS >0 was present in 254 (54%) patients. According to CACS and the Society of Cardiovascular Computed Tomography recommendations, 25% of the patients would be candidates for statin therapy and 17% would be candidates for changes in the current statin intensity; in 11 patients (8%), acetylsalicylic acid would be recommended. CONCLUSION In our study, more than half of the patients undergoing cardiac computed tomography before AF catheter ablation had CACS above zero. Our findings suggest that an opportunistic evaluation of CACS at the time of ablation can be an important tool to improve CV risk stratification, with important clinical and therapeutic implications.

中文翻译：

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冠状动脉钙评分筛查对接受消融的房颤患者心血管风险分层的影响。

简介 心房颤动 (AF) 与冠状动脉疾病之间存在明确的关联。冠状动脉钙化评分 (CACS) 是细化心血管 (CV) 风险分层的有用工具，并为初级 CV 预防的最佳策略提供信息。本研究旨在评估 CACS 机会性筛查对 AF 患者风险分层和预防性治疗决策的影响。方法 横断面研究包括 2017 年至 2019 年接受心脏计算机断层扫描以制定消融手术计划的 AF 或心房扑动患者。收集基线临床和人口统计数据。使用 Agatston 方法对无冠状动脉疾病的患者进行 CACS 评估。结果 总共纳入 474 名患者（93% 患有 AF，平均年龄 58 ± 10 岁，62% 为男性）。254 名 (54%) 患者存在 CACS >0。根据 CACS 和心血管计算机断层扫描协会的建议，25% 的患者将成为他汀类药物治疗的候选者，17% 的患者将成为改变当前他汀类药物强度的候选者；在 11 名患者（8%）中，建议使用乙酰水杨酸。结论 在我们的研究中，超过一半在 AF 导管消融前接受心脏计算机断层扫描的患者的 CACS 高于零。我们的研究结果表明，消融时对 CACS 进行机会性评估可以成为改善 CV 风险分层的重要工具，具有重要的临床和治疗意义。