Association Between Atrial Fibrillation and Atherosclerosis in Patients with Acute Lower Limb Arterial Ischemia: A Retrospective Cohort Study.

Objective: The correlation between atrial fibrillation (AF) and atherosclerosis remains inadequately elucidated. This study sought to examine the correlation between AF and atherosclerosis risk in patients with acute lower limb ischemia (ALLI).

Methods: This retrospective cohort study involved 175 patients with ALLI admitted to our hospital from May 2015 to May 2023, all of whom underwent CT angiography (CTA). We gathered data on patient demographics, risk factors, ischemic sites, and CTA results to explore the correlation between AF and atherosclerosis.

Results: AF was present in 46 out of 175 patients (26.3%). In the AF group, 25 patients (54.3%) were rated as IIb according to the Rutherford classification. According to the Trans-Atlantic Inter-Society Consensus II (TASC II) classification, 4 patients (9.3%) were classified as Grade D in the aorto-iliac lesions, while 19 patients (41.9%) were classified as Grade D in the femoral-popliteal lesions. The median calcification score was 1.3 ± 1.3 for the aorto-iliac lesions and 0.5 ± 0.8 for the femoral-popliteal lesions. Multiple logistic analyses showed a significant negative correlation between AF and atherosclerosis in the aorto-iliac and femoral-popliteal lesions.

Conclusions: This retrospective study indicates that AF is linked to a decreased risk of aorto-iliac and femoral-popliteal atherosclerosis in patients with ALLI, with significant variations in these associations upon adjustment for confounding factors. This finding contests established assumptions and requires validation through extensive, prospective cohort studies and fundamental research to clarify the underlying mechanisms.