Sung Woo Cho1, Jin Kyung Hwang1, Kwang Jin Chun1, Seung-Jung Park1, Kyoung-Min Park1, June Soo Kim1, Young Keun On2. 1. Division of Cardiology, Department of Internal Medicine, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 2. Division of Cardiology, Department of Internal Medicine, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: yk.on@samsung.com.
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.
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 AFpatients. METHODS: A total of 2126 AFpatients 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 AFpatients.
Authors: Juan Wang; Tao Zhang; Yan-Min Yang; Jun Zhu; Han Zhang; Xing-Hui Shao Journal: Ann Noninvasive Electrocardiol Date: 2022-03-03 Impact factor: 1.485
Authors: Pietro Scicchitano; Marco Tucci; Maria Consiglia Bellino; Francesca Cortese; Annagrazia Cecere; Micaela De Palo; Francesco Massari; Pasquale Caldarola; Francesco Silvestris; Marco Matteo Ciccone Journal: Cardiovasc Drugs Ther Date: 2021-06 Impact factor: 3.727