Key result
AF linked to ~82% lower incidence of cerebral atherosclerosis stenosis vs. no AF.
Why the study?
The association between non-valvular atrial fibrillation and cerebral atherosclerosis stenosis is undefined.
Does non-valvular atrial fibrillation reduce the incidence of cerebral atherosclerotic stenosis in patients undergoing CTA/DSA?
Cross-Sectional (n=3,176)
Does non-valvular atrial fibrillation reduce the incidence of cerebral atherosclerotic stenosis in patients undergoing CTA/DSA?
Effect estimate: OR 0.177 (95% CI 0.133-0.236)
Absolute Event Rate: 40.5% vs 73.8%
p-value: p=<0.001
Non-valvular atrial fibrillation is paradoxically associated with a lower incidence and severity of cerebral atherosclerotic stenosis in patients undergoing CTA/DSA.
Caution warranted against assuming atherosclerotic etiology in AF stroke; leaves open non-atherosclerotic mechanisms requiring prospective evaluation.
Background and aims The association between non-valvular atrial fibrillation (NVAF) and cerebral atherosclerosis stenosis is undefined. This study aims to investigate the impact of NVAF on cerebral atherosclerosis stenosis and to analyze independent predictors of atherosclerotic stenosis occurrence in NVAF patients. Methods A total of 3,176 patients (2,225 patients diagnosed as cerebral atherosclerosis stenosis and 351 patients diagnosed as NVAF) admitted for CTA/DSA examination were included in the study between January 2022 to December 2024. Demographic characteristics, clinical information, laboratory data and imaging information were collected. Results The incidence of cerebral atherosclerosis stenosis in patients with AF was significantly lower than patients without AF (40.5% vs. 73.8%, P<0.001). Following multivariate logistic regression analysis, AF was significantly associated with cerebral atherosclerosis stenosis (OR = 0.177, 95% CI = 0.133 - 0.236, P < 0.001). In AS group, the vascular stenosis in AF patients occurs more in anterior circulation extracranial artery (73.2% vs. 58.1%, P<0.001) and posterior circulation extracranial artery (45.8% vs. 36.0%, P = 0.019). Furthermore, patients in the AF group were more likely to experience mild stenosis (32.4% vs. 24.6 %, P = 0.038). In AF group, cerebral atherosclerosis stenosis was significantly associated with heart rate (OR = 0.979, 95% CI = 0.963-0.996, P = 0.018) and diastolic blood pressure (OR = 1.069, 95% CI = 1.044-1.095, P<0.001) at admission. Conclusions AF could weaken cerebral vascular stenosis caused by atherosclerosis. Heart rate and diastolic blood pressure are independent predictors of cerebral atherosclerosis stenosis in patients with AF. Conflict of interest Shumeng Li: nothing to disclose
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Li et al. (2026) conducted a cross-sectional in Cerebral atherosclerosis stenosis and non-valvular atrial fibrillation (n=3,176). Atrial fibrillation vs. No atrial fibrillation was evaluated on Cerebral atherosclerosis stenosis (OR 0.177, 95% CI 0.133-0.236, p=<0.001). Atrial fibrillation was associated with a significantly lower incidence of cerebral atherosclerosis stenosis compared to no AF (40.5% vs. 73.8%; OR 0.177, 95% CI 0.133-0.236, P<0.001).
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