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Impact of moderate to severe renal impairment on long-term clinical outcomes in patients with atrial fibrillation.

Abstract：

BACKGROUND:The deleterious effect of renal impairment in non-valvular atrial fibrillation (AF) patients has recently been reported. We investigated the impact of moderate to severe renal impairment on long-term clinical outcomes in AF patients. METHODS:A total of 2126 AF patients were enrolled and divided into two groups according to ≥ or <60mL/min estimated glomerular filtration rate (eGFR). Clinical outcomes including all-cause death, cardiac death, ischemic stroke (IS), bleeding, and admission for heart failure (HF) were analyzed. RESULTS:Compared to the ≥60mL/min eGFR group, <60mL/min eGFR patients were older; had a higher proportion of females; were more likely to have diabetes, hypertension, and history of stroke; and had higher CHADS2, CHA2DS2-VASc, and HAS-BLED scores. During the follow-up period (median 6.23 years), all-cause death, bleeding, admission for HF, and progression to persistent or permanent AF were significantly increased in the <60mL/min eGFR group compared to the ≥60mL/min eGFR group. After multivariate Cox regression analyses, <60mL/min eGFR increased the risk of all-cause death [hazard ratio (HR): 1.84; 95% confidence interval (CI): 1.03-3.28, p=0.04] and bleeding (HR: 1.28; 95% CI: 1.04-1.57, p=0.02). IS was only significantly increased in the <60mL/min eGFR group not receiving antithrombotic treatment. CONCLUSION:Moderate to severe renal impairment is a poor prognostic factor of long-term clinical outcomes in AF patients.

journal_name

J Cardiol

journal_title

Journal of cardiology

authors

Cho SW,Hwang JK,Chun KJ,Park SJ,Park KM,Kim JS,On YK

doi

10.1016/j.jjcc.2016.04.006

subject

Has Abstract

pub_date

2017-03-01 00:00:00

pages

577-583

issue

3

eissn

0914-5087

issn

1876-4738

pii

S0914-5087(16)30055-7

journal_volume

69

pub_type

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