Relationship between carotid intima-media thickness and non valvular atrial fibrillation type

Objective: Carotid intima-media thickness (cIMT) is a surrogate marker of subclinical atherosclerosis andit is able to predict both coronary and cerebral vascular events. No data exist on the association betweencIMT and non valvular atrial fibrillation (NVAF) type. We conduct this study with the aim to analyze theassociation between abnormal cIMT and NVAF type. Methods: A cross-sectional study of the “Atrialfibrillation Registry for Ankle-brachial index Prevalence Assessment-Collaborative Italian Study (ARAPACIS)”has been performed. Among 2027 patients enrolled in the ARAPACIS, 673 patients, who underwentcarotid ultrasound examination to assess cIMT, were included in the study. Results: Among theentire 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 thanthose with normal cIMT (0.90 mm). These patients had more permanent/persistent NVAF andCHA2DS2-VASc score 2 (p < 0.0001) compared to those with cIMT <0.90 mm. Excluding all patientsaffected by previous cardiovascular disease, logistic regression analysis showed that independent predictorsof abnormal cIMT were: age class 65e74 yrs. (p < 0.001), age class 75 yrs. (p < 0.001), arterialhypertension (p < 0.001), calcium-channel blockers use (p < 0.001) and persistent/permanent NVAF(p ¼ 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 cIMTwas particularly evident in persistent/permanent NVAF suggesting a more elevated atheroscleroticburden in patients with long-standing NVAF. T