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Non-Coronary Artery Disease Scarring: Could It Serve As a Possible Biomarker for Atrial Fibrillation?

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Non-Coronary Artery Disease Scarring: Could It Serve As a Possible Biomarker for Atrial Fibrillation? J Cardiovasc Dis Med 2019 Inno Journal of Volume 2.1 Cardiovascular Disease and Medicine Non-Coronary Artery Disease Scarring: Could it Serve as a Possible Biomarker for Atrial Fibrillation? Gadhia R1* 1Houston Methodist Neurological Institute, USA 2Texas A M University, USA Volpi J1 2 3University of Virginia School of Medicine, USA HooksNorkiewicz R3 Z Abstract Article Information In a series of patients with cerebrovascular disease, Background: Article Type: Research delayed enhancement cardiac magnetic resonance (DE-CMR) detected Article Number: JCDM116 non-coronary artery disease (non-CAD) scarring in 15.3% of stroke Received Date: 03 April, 2019 patients and 4.8% in TIA patients [1]. One hypothesis for this trend Accepted Date: 12 April, 2019 was that high incidence of non-CAD scarring may be a result of small Published Date: 19 April, 2019 biomarker for non- CAD scarring, earlier diagnosis and treatment could *Corresponding Author: Dr. Rajan R Gadhia, Houston potentiallymicroemboli decrease and a biomarker the number for of atrial cryptogenic fibrillation embolic [2]. Ifstrokes validated through as a Methodist Neurological Institute, USA. Tel: 2815075166; earlier anticoagulation therapy and decrease the economic burden of Fax: 7137937019; Email: rrgadhia(at)houstonmethodist.org stroke-related treatment and healthcare costs [3,4]. Citation: Gadhia R, Norkiewicz Z, Volpi J, Hooks R (2019) Methods: EPIC Slicer dicer was utilized to search for “stroke” and Non-Coronary Artery Disease Scarring: Could it Serve as a cardiac MRI”. 87 patients’ medical records were accessed in order to Possible Biomarker for Atrial Fibrillation? J Cardiovasc Dis obtain information regarding the factors stated previously, the presence Med. Vol: 2, Issu: 1 (04-07). were evaluated to see if there was an association between non-CAD Copyright: © 2019 Gadhia R. This is an open-access of atrial fibrillation, and cMRI results. Patients’ medical histories article distributed under the terms of the Creative Commons consumption, diabetes, hypertension, hyperlipidemia, renal disease, Attribution License, which permits unrestricted use, historyscarring ofand myocardial atrial fibrillation. infarction Factors (MI), such seizures, as gender, and smoking, race was alcohol also distribution, and reproduction in any medium, provided the original author and source are credited. analyzed to see if these factors had any effect on the prevalence of non- CADResults: scarring Large and differences atrial fibrillation. in the occurrences of non-CAD and CAD scarring were seen with gender, smoking, diabetes, hypertension, hyperlipidemia, renal disease, history of MI, and seizures in patients morewith no non-CAD documented and CAD atrial scarring fibrillation. occurrences There werewhen more smoking, non-CAD diabetes, and CAD scarring males with no atrial fibrillation compared to females and inor thehypertension absence of wasrenal present disease, with history no ofatrial MI, andfibrillation. seizures; Non-CAD these trends and withCAD scarringrenal disease occurrences and seizures with no were atrial unexpected. fibrillation were more prevalent Conclusion: Even though trends were observed with the various factors, scarring, and the presence or absence of atrial fibrillation, our study thisfound patient no statistically sample, we significant saw no association evidence that between suggests non-CAD certain scarring factors impact non-CAD or CAD scarring with and without atrial fibrillation. In the unexpected scarring trend seen with no renal disease or seizures present.and atrial fibrillation. Future studies could be conducted to explore Keywords: Non-Coronary Artery Disease, EPIC Slicer dicer, Atrial Fibrillation, cMRI. www.innovationinfo.org Introduction males and females, occurrences of CAD scarring with and of non-CAD scarring with and without atrial fibrillation in occurrences of non-CAD scarring with and without atrial of deathIn 2013, [3]. approximately Several risk 6.5factors million for people stroke worldwide include Atrial died without atrial fibrillation in current and former smokers, due to stroke, making stroke the fifth ranked global cause and diabetes [5]. In addition to stroke, 17.3 million people drinkersfibrillation andin currentnon-drinkers, and former occurrences smokers, ofoccurrences non-CAD worldwideFibrillation died(AF), due hypertension, to cardiovascular hyperlipidemia, disease (CVD) smoking, [3]. of CAD scarring with and without atrial fibrillation in and non-drinkers, occurrences of CAD scarring with and failure, chronic kidney disease, and coronary artery disease scarring with and without atrial fibrillation in drinkers Common outcomes of CVD include atrial fibrillation, heart (CAD), which can develop due to factors such as hypertension, occurrences of non-CAD scarring with and without atrial without atrial fibrillation in diabetics and non-diabetics, stroke and CVD deaths per year continue to remain high as dyslipidemia, smoking, or diabetes [6,7]. The number of the prevalence of stroke risk factors and CVD related health withfibrillation and without in diabetics hypertension, and non-diabetics, occurrences occurrences of non-CAD of CAD scarring with and without atrial fibrillation in patients and without hypertension, occurrences of CAD scarring issues continue to increase, especially atrial fibrillation scarring with and without atrial fibrillation in patients with [3,6]. Atrial fibrillation is the most common arrhythmia and without hyperlipidemia, occurrences of non-CAD scarring byincreases techniques the risk such of stroke as in-hospital by five [8]. monitoring, Detection rate Insertable of atrial with and without atrial fibrillation in patients with and fibrillation remains low with 0-25% of incidences detected Cardiac Monitors (ICMs), Serial Electrocardiography (ECG), without hyperlipidemia, occurrences of CAD scarring with with and without atrial fibrillation in patients with and effective biomarker is needed to increase the detection rate renal disease, occurrences of non-CAD scarring with and and cardiac magnetic resonance imaging (cMRI) [2,4]. An and without atrial fibrillation in patients with and without or recurrent stroke prevention. Unfortunately, nearly a third disease, occurrences of CAD scarring with and without of atrialpatients fibrillation who present and lead with to earlierembolic treatment strokes andof unknown primary without atrial fibrillation in patients with and without renal source are discharged on antiplatelet therapy, which is an MI, occurrences of non-CAD scarring with and without atrial fibrillation in patients with and without history of occurrences of CAD scarring in patients with and without ineffectiveA possible regimen biomarker for paroxysmal could be AF.discovered using cMRI, an imaging technique that can detect cardiac pathologies seizures,atrial fibrillation occurrences in patients of non-CAD with and scarring without in historypatients of with MI, such as heart arrhythmia and myocardial scarring - scar and without seizures, occurrences of CAD scarring with tissue that forms when muscular tissue of the heart dies American, and Asian race, and occurrences of non-CAD and without atrial fibrillation in patients of white, African due to myocardial infarction [2,9]. cMRI could be used to of white, African American, and Asian race. All data was Transientdiscover a Ischemic possible Attackbiomarker (TIA) of patients AF due into thisfindings study, from non- a thenscarring sent withfor statistical and without analysis atrial to determinefibrillation if inany patients trends CADrecently scarring published was detected 2014 study. in 15.3% Of 85 andischemic 4.8% strokein stroke and and 21 approximately 3 times more prevalent in stroke patients betweenResults the various bar graphs were statistically significant. thanTIA patients, TIA patients, respectively non-CAD [2]. scarring Since could non-CAD possibly scarring be linked was was approximately double the percentage of CAD scarring From all 87 patients and 43 scarring occurrences, there CVD.to ischemic If non-CAD stroke scarring [2]. Thus, is found non-CAD to be a scarringstrong predictor could be for a biomarker for atrial fibrillation, a risk factor for stroke and inoccurrences scarring occurrences with atrial andfibrillation similar thanpatterned non-CAD graphs scarring were stroke, the number of global stroke deaths per year, and the occurrences with atrial fibrillation. The largest differences underlying atrial fibrillation, this would decrease the risk of noted a few trends with gender, race, diet, renal dysfunction, seizuresseen in factors and smoking with no whenatrial comparedfibrillation. with In our scarring cohort, and we amountMethods of money spent on stroke related healthcare [3,10]. CVD. In looking through the literature, there are a number EPIC Slicer dicer was utilized to search for “stroke” and of studies that have sought to try to explain the generally “cardiac MRI” which gave yield to 87 patients. Each patient’s observed trends. The non-CAD and CAD scarring graphs for medical records were accessed in order to examine the studied factors (gender, smoking, alcohol consumption, more males with scarring than females. The scarring trend diabetes, hypertension, hyperlipidemia, renal disease, observedgender with in nomales atrial is fibrillationlikely from revealed differences that inthere baseline were history of Myocardial Infarction (MI), seizures, and race), results were analyzed to determine if the patient had CAD menrisks. hadA
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