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Carotid Atherosclerosis in Patients with Atrial Fibrillation

  • Zhaojia Wang
  • Panagiotis Korantzopoulos
  • Tong LiuEmail author
Evidence-Based Medicine, Clinical Trials and Their Interpretations (L. Roever, Section Editor)
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Abstract

Purpose of Review

This review aims to explore the relationship between AF and carotid atherosclerosis, and the impact on the outcomes of cardiovascular and cerebrovascular events. Also, our aim is to critically review current knowledge and delineate future directions for effective treatment or prevention as well as strategies for improvement of the quality of life and survival.

Recent Findings

Atrial fibrillation (AF) is the most common arrhythmia, increasing the risk of stroke and cardiovascular morbidity and mortality representing a significant worldwide public health problem. On the other hand, carotid artery atherosclerosis can also significantly increase the risk of stroke, transient ischemic attack (TIA), and death.

Summary

Firstly, we report epidemiological data on AF patients in different countries and regions having carotid artery abnormalities such as carotid artery plaque formation, atherosclerotic, and even stenosis. Despite geographical variations, these abnormalities were more frequent in AF patients and correlated with the duration of AF and the value of CHA2DS2-VASc score. Moreover, it is evident that AF patients with carotid artery abnormalities have significantly increased risk of adverse outcomes from the heart and brain. According to the CHA(2)DS2 (-VASc) score, AF patients are managed with anticoagulation therapy. Reviewing existing data on the treatment for stroke prevention in patients with AF, carotid artery disease, or both, we found that antiplatelet therapy could be combined with anticoagulant therapy appropriately in certain circumstances. In addition, some emerging technologies, such as the percutaneous permanent carotid filter, may be used safely and effectively to prevent the occurrence of stroke in patients both with AF and carotid artery atherosclerosis.

Keywords

Atrial Fibrillation Carotid Atherosclerosis Anticoagulant Therapy Antiplatelet Therapy 

Notes

Funding Information

This work was supported by grants (81970270, 30900618, 81270245, and 81570298 to T.L.) from the National Natural Science Foundation of China and Tianjin Natural Science Foundation (16JCZDJC34900 to T.L.).

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Zhaojia Wang
    • 1
  • Panagiotis Korantzopoulos
    • 2
  • Tong Liu
    • 1
    Email author
  1. 1.Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of CardiologyThe Second Hospital of Tianjin Medical UniversityTianjinChina
  2. 2.First Department of Cardiology, Medical SchoolUniversity of IoanninaIoanninaGreece

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