To investigate the prevalence of mital valve calcium (MVC), mitral annular calcium (MAC), and aortic valve calcium (AVC) in patients with non-valvular atrial fibrillation (AF) treated with warfarin versus no warfarin.
Of 1155 patients, mean age 74 years, with AF, 725 (63%) were treated with warfarin and 430 (37%) without warfarin. The prevalence of MVC, MAC, and AVC was investigated in these 1155 patients by 2-dimensional echocardiograms.
MVC was present in 89 of 725 patients (12%) on warfarin versus 36 of 430 patients (8%) not on warfarin (p = 0.039). MAC was present in 275 of 725 patients (38%) on warfarin versus 140 of 430 patients (33%) not on warfarin (p = 0.066). AVC was present in 351 of 725 patients (48%) on warfarin versus 166 of 430 patients (39%) not on warfarin (p = 0.001). MVC, MAC, or AVC was present in 473 of 725 patients (65%) on warfarin versus 225 of 430 patients (52%) not on warfarin (p < 0.0001). Using the variables age, gender, race, ejection fraction, smoking, hypertension, diabetes, dyslipidemia, coronary artery disease (CAD), glomerular filtration rate, calcium, phosphorus, calcium-phosphorus product, alkaline phosphatase, use of aspirin, beta blockers, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, and statins, stepwise logistic regression analysis showed that significant risk factors associated with MVC, MAC, or AVC were CAD (odds ratio = 13.6, p < 0.0001), use of warfarin (odds ratio = 2.3, p < 0.0001), age (1.08 per 1 year increase, p < 0.0001), calcium-phosphorus product (odds ratio = 1.02, p = 0.015), and dyslipidemia (odds ratio = 0.13, p < 0.0001).
Use of warfarin in patients with AF is associated with an increased prevalence of MVC, MAC, or AVC.
Use of warfarin in patients with AF is associated with an increased prevalence of MVC, MAC, or AVC. Alternative drugs are needed to treat AF.
Chandrasekar Palaniswamy, No Financial Disclosure Information; No Product/Research Disclosure Information