Wu-Tao Zeng1, Xiu-Ting Sun1, Kai Tang1, Wei-Yi Mei1, Li-Juan Liu1, Qing Xu1, Yun-Jiu Cheng2. 1. From the Department of Cardiology, the Eastern Hospital of the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China. 2. From the Department of Cardiology, the Eastern Hospital of the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China. cheng831011@sina.com.
Abstract
BACKGROUND AND PURPOSE: Chronic kidney disease may increase the risk for ischemic stroke or systemic embolism in patients with nonvalular atrial fibrillation (AF). We conducted a meta-analysis to summarize all published studies to investigate the link between chronic kidney disease and risk of thromboembolic events in AF. METHODS: We performed a literature search using MEDLINE (source PubMed, 1966 to July, 2014) and EMBASE (1980 to July 2014) with no restrictions. Pooled effect estimates were obtained by using random-effects meta-analysis. RESULTS: Eighteen studies involving 538 479 patients and 41 719 incident thromboembolic events were identified. From the pooled analysis, AF patients with estimated glomerular filtration rate <60 mL/min compared with those with estimated glomerular filtration rate ≥60 mL/min experienced a significantly increased risk for developing thromboembolic events (relative risk, 1.62 [95% confidence interval, 1.40-1.87; P<0.001]). The annual rate of thromboembolic events increased by 0.41% (95% confidence interval, 0.17%-0.65%) for a 10 mL/min decrease in renal function. Addition of renal impairment to CHADS2 slightly improved the stroke risk stratification. CONCLUSIONS: Impaired renal function is an independent predictor of stroke or systemic embolism in patients with nonvalvular AF. Consideration of renal function may improve stroke risk stratification in patients with AF.
BACKGROUND AND PURPOSE:Chronic kidney disease may increase the risk for ischemic stroke or systemic embolism in patients with nonvalular atrial fibrillation (AF). We conducted a meta-analysis to summarize all published studies to investigate the link between chronic kidney disease and risk of thromboembolic events in AF. METHODS: We performed a literature search using MEDLINE (source PubMed, 1966 to July, 2014) and EMBASE (1980 to July 2014) with no restrictions. Pooled effect estimates were obtained by using random-effects meta-analysis. RESULTS: Eighteen studies involving 538 479 patients and 41 719 incident thromboembolic events were identified. From the pooled analysis, AFpatients with estimated glomerular filtration rate <60 mL/min compared with those with estimated glomerular filtration rate ≥60 mL/min experienced a significantly increased risk for developing thromboembolic events (relative risk, 1.62 [95% confidence interval, 1.40-1.87; P<0.001]). The annual rate of thromboembolic events increased by 0.41% (95% confidence interval, 0.17%-0.65%) for a 10 mL/min decrease in renal function. Addition of renal impairment to CHADS2 slightly improved the stroke risk stratification. CONCLUSIONS: Impaired renal function is an independent predictor of stroke or systemic embolism in patients with nonvalvular AF. Consideration of renal function may improve stroke risk stratification in patients with AF.
Authors: Anna Michalska; Iwona Gorczyca; Magdalena Chrapek; Agnieszka Kapłon-Cieślicka; Beata Uziębło-Życzkowska; Katarzyna Starzyk; Olga Jelonek; Monika Budnik; Monika Gawałko; Paweł Krzesiński; Agnieszka Jurek; Piotr Scisło; Janusz Kochanowski; Marek Kiliszek; Grzegorz Gielerak; Krzysztof J Filipiak; Grzegorz Opolski; Beata Wożakowska-Kapłon Journal: Medicine (Baltimore) Date: 2020-06-19 Impact factor: 1.817
Authors: David Collister; Jeff S Healey; David Conen; K Scott Brimble; Claudio Rigatto; Ziv Harel; Manish M Sood; Michael Walsh Journal: Can J Kidney Health Dis Date: 2019-01-08