Renal function and mortality in patients with atrial fibrillation.
Journal
Journal of cardiovascular medicine (Hagerstown, Md.)
ISSN: 1558-2035
Titre abrégé: J Cardiovasc Med (Hagerstown)
Pays: United States
ID NLM: 101259752
Informations de publication
Date de publication:
01 07 2022
01 07 2022
Historique:
entrez:
28
6
2022
pubmed:
29
6
2022
medline:
1
7
2022
Statut:
ppublish
Résumé
The aim of this study is to examine the association of the presence of chronic kidney disease (CKD) and estimated glomerular filtration rate (eGFR) values with mortality in patients with atrial fibrillation. This posthoc analysis of a randomized controlled trial consisted of hospitalized patients with atrial fibrillation who were followed up for a median of 2.7 years after discharge. Kaplan-Meier curves, multivariate Cox-regression and spline curves were utilized to assess the association of CKD, CKD stages 2-5 according to the KDOQI guidelines, and the continuum of eGFR values with the primary outcome of all-cause death, and the secondary outcome of cardiovascular mortality. Out of 1064 hospitalized patients with atrial fibrillation, 465 (43.7%) had comorbid CKD. The presence of CKD was associated with an increased risk for both all-cause and cardiovascular mortality following hospitalization [adjusted hazard ratio (aHR): 1.60; 95% confidence intervals (95% CIs): 1.25-2.05 and aHR: 1.74; 95% CI: 1.30-2.33, respectively]. The aHRs for all-cause mortality in CKD stages 2-5, as compared with CKD stage 1 were 2.18, 2.62, 4.20 and 3.38, respectively (all P < 0.05). In spline curve analyses, eGFR values lower than 50 ml/min/1.73 m2 were independent predictors of higher all-cause and cardiovascular mortality. In recently hospitalized patients with atrial fibrillation, the presence of CKD was independently associated with decreased survival, which was significant across CKD stages 2-5, as compared with CKD stage 1. Values of eGFR lower than 50 ml/min/1.73 m2 were incrementally associated with worse prognosis.
Identifiants
pubmed: 35763763
doi: 10.2459/JCM.0000000000001308
pii: 01244665-202207000-00003
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
430-438Informations de copyright
Copyright © 2022 Italian Federation of Cardiology - I.F.C. All rights reserved.
Références
Kornej J, Börschel CS, Benjamin EJ, Schnabel RB. Epidemiology of atrial fibrillation in the 21st century: novel methods and new insights. Circ Res 2020; 127:4–20.
Conen D. Epidemiology of atrial fibrillation. Eur Heart J 2018; 39:1323–1324.
Odutayo A, Wong CX, Hsiao AJ, Hopewell S, Altman DG, Emdin CA. Atrial fibrillation and risks of cardiovascular disease, renal disease, and death: systematic review and meta-analysis. BMJ 2016; 354:i4482.
Hohnloser SH, Hijazi Z, Thomas L, et al. Efficacy of apixaban when compared with warfarin in relation to renal function in patients with atrial fibrillation: insights from the ARISTOTLE trial. Eur Heart J 2012; 33:2821–2830.
Nicola LD, Zoccali C. Chronic kidney disease prevalence in the general population: heterogeneity and concerns. Nephrol Dial Transplant 2016; 31:331–335.
Ramagopalan SV, Stamp E, Sammon CJ, et al. Renal function and oral anticoagulant treatment of incident nonvalvular atrial fibrillation: a retrospective study. Future Cardiol 2019; 15:301–309.
Benjamin EJ, Wolf PA, D’Agostino RB, Silbershatz H, Kannel WB, Levy D. Impact of atrial fibrillation on the risk of death: the Framingham Heart Study. Circulation 1998; 98:946–952.
Tonelli M, Wiebe N, Culleton B, et al. Chronic kidney disease and mortality risk: a systematic review. J Am Soc Nephrol 2006; 17:2034–2047.
Nakagawa K, Hirai T, Takashima S, et al. Chronic kidney disease and CHADS(2) score independently predict cardiovascular events and mortality in patients with nonvalvular atrial fibrillation. Am J Cardiol 2011; 107:912–916.
Olesen JB, Lip GYH, Kamper AL, et al. Stroke and bleeding in atrial fibrillation with chronic kidney disease. N Engl J Med 2012; 367:625–635.
Banerjee A, Fauchier L, Vourc’ HP, et al. A prospective study of estimated glomerular filtration rate and outcomes in patients with atrial fibrillation: the loire valley atrial fibrillation project. Chest 2014; 145:1370–1382.
Samaras A, Kartas A, Vasdeki D, et al. Rationale and design of a randomized study comparing Motivational Interviewing to Support Oral Anticoagulation adherence versus usual care in patients with nonvalvular atrial fibrillation: the MISOAC-AF trial. Hell J Cardiol 2020; 61:453–454.
Tzikas A, Samaras A, Kartas A, et al. Motivational Interviewing to Support Oral AntiCoagulation adherence in patients with nonvalvular Atrial Fibrillation (MISOAC-AF): a randomised clinical trial. Eur Heart J Cardiovasc Pharmacother 2020; 7:63–71.
Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J 2016; 37:2893–2962.
Anon. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 2002; 39:S1–S266.
Inker LA, Astor BC, Fox CH, et al. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for the evaluation and management of CKD. Am J Kidney Dis 2014; 63:713–735.
Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron 1976; 16:31–41.
Boriani G, Laroche C, Diemberger I, et al. Glomerular filtration rate in patients with atrial fibrillation and 1-year outcomes. Sci Rep 2016; 6:1–11.
Godino C, Melillo F, Rubino F, et al. Real-world 2-year outcome of atrial fibrillation treatment with dabigatran, apixaban, and rivaroxaban in patients with and without chronic kidney disease. Intern Emerg Med 2019; 14:1259–1270.
Chou CY, Chen JY, Liu JH, et al. Atrial fibrillation linked to vascular access thrombosis in chronic hemodialysis patients. J Atheroscler Thromb 2011; 18:448–453.
Bansal N, Xie D, Tao K, et al. Atrial fibrillation and risk of ESRD in adults with CKD. Clin J Am Soc Nephrol 2016; 11:1189–1196.
Carrero JJ, Trevisan M, Sood MM, et al. Incident atrial fibrillation and the risk of stroke in adults with chronic kidney disease: the Stockholm CREAtinine measurements (SCREAM) project. Clin J Am Soc Nephrol 2018; 13:1314–1320.
Hung TW, Huang JY, Jong GP. Long-term outcomes of dialysis in patients with chronic kidney disease and new-onset atrial fibrillation: a population-based cohort study. PLoS One 2019; 14:1–10.
Arnson Y, Hoshen M, Berliner-Sendrey A, et al. Risk of stroke, bleeding, and death in patients with nonvalvular atrial fibrillation and chronic kidney disease. Cardiol 2020; 145:178–186.
Guo Y, Wang H, Zhao X, et al. Sequential changes in renal function and the risk of stroke and death in patients with atrial fibrillation. Int J Cardiol 2013; 168:4678–4684.
Goto S, Angchaisuksiri P, Bassand J-P, et al. Management and 1-year outcomes of patients with newly diagnosed atrial fibrillation and chronic kidney disease: results from the Prospective GARFIELD - AF Registry. J Am Heart Assoc 2019; 8:e010510.
Eadington D, Plant W, Winney R. Chronic renal failure. Practitioner 1993; 237:64–69.
Ma L, Zhao S. Risk factors for mortality in patients undergoing hemodialysis: a systematic review and meta-analysis. Int J Cardiol 2017; 238:151–158.
Bradbury BD, Fissell RB, Albert JM, et al. Predictors of early mortality among incident US hemodialysis patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS). Clin J Am Soc Nephrol 2007; 2:89–99.
Grassi G. Sympathetic neural activity in hypertension and related diseases. Am J Hypertens 2010; 23:1052–1060.
Kiuchi MG, Mion D. Chronic kidney disease and risk factors responsible for sudden cardiac death: a whiff of hope? Kidney Res Clin Pract 2016; 35:3–9.
Tonelli M, Klarenbach SW, Lloyd AM, et al. Higher estimated glomerular filtration rates may be associated with increased risk of adverse outcomes, especially with concomitant proteinuria. Kidney Int 2011; 80:1306–1314.
Chandrajay D. Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis. Ann Clin Biochem Int J Lab Med 2010; 47:578–1578.
Mottillo S, Filion KB, Genest J, et al. The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis. J Am Coll Cardiol 2010; 56:1113–1132.
Marietta M, Coluccio V, Boriani G, Luppi M. Effects of Antivitamin k oral anticoagulants on bone and cardiovascular health. Eur J Intern Med 2020; 79:1–11.
Rubboli A, Fresco C, Paciaroni M, et al. How lower doses of direct oral anticoagulants are interpreted in clinical practice. J Cardiovasc Med 2021; 22:924–928.
Stanifer JW, Pokorney SD, Chertow GM, et al. Apixaban versus warfarin in patients with atrial fibrillation and advanced chronic kidney disease. Circulation 2020; 141:1384–1392.
Goto S, Angchaisuksiri P, Bassand JP, et al. Management and 1-year outcomes of patients with newly diagnosed atrial fibrillation and chronic kidney disease: results from the prospective garfield-af registry. J Am Heart Assoc 2019; 8:e010510.
Siontis KC, Zhang X, Eckard A, et al. Apixaban. Dialysis 2019; 138:1519–1529.
Coleman CI, Kreutz R, Sood NA, et al. Rivaroxaban versus warfarin in patients with nonvalvular atrial fibrillation and severe kidney disease or undergoing hemodialysis. Am J Med 2019; 132:1078–1083.
Hindricks G, Potpara T, Dagres N, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 2021; 42:373–498.
Potpara TS, Lip GYH, Blomstrom-Lundqvist C, et al. The 4S-AF scheme (Stroke Risk; Symptoms; Severity of Burden; Substrate): a novel approach to in-depth characterization (rather than classification) of atrial fibrillation. Thromb Haemost 2021; 121:270–278.