Key result
Mitral annular calcification was associated with a significantly increased risk of developing incident atrial fibrillation (OR 2.34) and major adverse cardiac events in patients with atrial fibrillation.
Why the study?
The reported incidence of AF in patients with MAC varies widely from 5.4% to 47.1%.
Does the presence of mitral annular calcification increase the risk of incident atrial fibrillation and major cardiac adverse events?
Meta-Analysis (n=23,958)
Does the presence of mitral annular calcification increase the risk of incident atrial fibrillation and major cardiac adverse events?
Odds Ratio: 2.34 (95% CI 1.91–2.85)
p-value: p=<0.001
Mitral annular calcification is a significant risk factor for both the development of atrial fibrillation and subsequent major adverse cardiac events in those with AF.
Mitral annular calcification may warrant closer AF surveillance; extends pooled observational data and supports prospective validation studies.
BACKGROUND: The incidence of atrial fibrillation (AF) varies from 5.4% to 47.1% in patients with mitral annulus calcification (MAC). We conducted a systematic review and meta-analysis on the association between MAC and AF, as well as the relation between MAC and major cardiac adverse events (MACEs) in AF patients. METHODS: We conducted comprehensive search for literature on associations between MAC and AF using the following databases: MEDLINE, PubMed, Embase, and the Web of Science. The pooled odds ratio (OR) or relative risk and the corresponding 95% confidence intervals (CIs) were calculated to assess the relationship between MAC and AF, as well as the rates of MACEs in AF patients with or without MAC. RESULTS: Thirteen studies met our eligibility criteria on associations between MAC and AF, including 6232 patients with MAC and 15,199 patients without MAC. Moreover, 5 studies met our eligibility criteria on the rates of MACEs in AF patients with or without MAC. The pooled analysis demonstrated a statistically significant increased risk of development of incident AF in patients with MAC than those without MAC (random effects OR: 2.34; 95% CI: 1.91, 2.85; P = .000). And the pooled analysis demonstrated a statistically significant increased risk of development of MACEs in AF patients with MAC (random effects OR: 2.34; 95% CI: 1.24, 4.41; P = .009). CONCLUSION: MAC was independently associated with AF and AF patients with MAC were at greater risk for cardiovascular and cerebrovascular events.
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Li et al. (2019) conducted a meta-analysis in Atrial Fibrillation and Mitral Annular Calcification (n=23,958). Mitral annular calcification vs. Without mitral annular calcification was evaluated on Development of incident atrial fibrillation (OR 2.34, 95% CI 1.91-2.85, p=<0.001). Mitral annular calcification was associated with a significantly increased risk of developing incident atrial fibrillation (OR 2.34) and major adverse cardiac events in patients with atrial fibrillation.
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