Key result
Higher SYNTAX CABG score is linked to ~8% higher odds of AF in chronic coronary syndrome.
Why the study?
Identifying CCS patients at increased likelihood of AF is clinically relevant, especially for silent or paroxysmal arrhythmia, and established coronary risk scores may capture cumulative burden to assist in risk stratification.
Do established clinical and angiographic coronary risk scores identify an increased likelihood of atrial fibrillation in patients with suspected chronic coronary syndrome?
Cross-Sectional (n=131)
Investigators calculating clinical scores were blinded to angiographic findings and rhythm status
No
Do established clinical and angiographic coronary risk scores identify an increased likelihood of atrial fibrillation in patients with suspected chronic coronary syndrome?
Odds Ratio: 1.08
p-value: p=0.040
Routinely available clinical and angiographic coronary risk scores—particularly SYNTAX PCI and CABG—are significantly associated with atrial fibrillation presence and phenotype in chronic coronary syndrome patients, offering a practical tool for targeted rhythm screening.
May aid AF detection via SYNTAX CABG in chronic coronary syndrome; hypothesis-generating and requires prospective validation before screening use.
Atrial fibrillation (AF) frequently coexists with chronic coronary syndrome (CCS), reflecting shared cardiovascular risk factors and structural remodeling pathways. Identifying CCS patients at increased likelihood of AF remains clinically relevant, particularly when arrhythmia is silent or paroxysmal. Background: We hypothesized that established clinical and angiographic risk scores used in CCS may capture cumulative cardiovascular burden and could therefore assist in AF risk stratification. The biomarker-based ABC-stroke score was incorporated as a biological reference framework reflecting myocardial stress and injury. Methods: This prospective, single-center proof-of-concept study included 131 consecutive patients undergoing invasive coronary angiography for suspected myocardial ischemia. Patients were classified according to rhythm status, irrespective of AF subtype. Coronary artery disease severity was quantified using the Gensini and SYNTAX (PCI and CABG) scores. Global cardiovascular risk was assessed using Framingham, ASCVD, SCORE2, and SCORE2-OP. Correlation analyses, ROC curves, and multivariable logistic regression were performed to evaluate associations between risk scores, coronary complexity, and AF. Results: Clinical and angiographic risk scores differed significantly according to rhythm status and AF phenotype. Patients with AF exhibited higher global cardiovascular risk and greater coronary anatomical complexity compared with those in sinus rhythm. SYNTAX PCI and SYNTAX CABG demonstrated moderate discriminative performance for AF detection (AUC 0.745 and 0.760, respectively), with SYNTAX CABG remaining independently associated with AF in multivariable analysis. Significant correlations were observed between traditional cardiovascular risk scores and SYNTAX-derived measures of coronary complexity, whereas correlations with the Gensini score were weaker. The ABC-stroke reference model showed a strong discriminative signal, consistent with its biological proximity to AF-related myocardial stress. Conclusions: Established clinical and angiographic risk scores used in CCS are associated with the presence and phenotype of AF. These findings suggest that routinely available coronary risk assessment tools may serve as practical instruments for identifying CCS patients at increased likelihood of AF, potentially facilitating targeted rhythm screening and earlier risk stratification.
No takes yet. Share an insight, caveat, or question.
Oancea et al. (2026) conducted a cross-sectional in Suspected chronic coronary syndrome (CCS) with or without atrial fibrillation (AF) (n=131). Clinical and angiographic coronary risk scores (SYNTAX CABG, SYNTAX PCI, Gensini, Framingham, ASCVD, SCORE2, SCORE2-OP) and ABC-stroke score vs. Sinus rhythm vs atrial fibrillation phenotypes (paroxysmal, persistent, permanent) was evaluated on Presence of atrial fibrillation (AF) in multivariable binary logistic regression (SYNTAX CABG independent association) (OR 1.080, p=0.040). SYNTAX CABG (OR 1.080, p=0.040; AUC 0.760) and the ABC-stroke score (OR 35.160, p=0.002; AUC 0.908) were independently associated with atrial fibrillation presence in chronic coronary syndrome.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: