Yoshihiro Tanaka1, Hayato Tada2, Satoshi Hara3, Kenshi Hayashi2, Ravi B Patel4, Tetsuo Nishikawa2, Atsushi Hashiba5, Masayuki Takamura2, Philip Greenland6, Masa-Aki Kawashiri2. 1. Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan. Electronic address: y.tanaka@northwestern.edu. 2. Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan. 3. Division of Rheumatology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan. 4. Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. 5. Kanazawa Medical Association, Kanazawa, Japan. 6. Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Abstract
BACKGROUND: Although proteinuria has been associated with incident atrial fibrillation (AF) in Western countries, the association has not been investigated in the general Japanese population. METHODS: Participants aged ≥40 years who underwent the Japanese specific health check-up in Kanazawa City in 2013 and who completed a urine dipstick test were included in this study. Exposure was considered as presence or absence of proteinuria (≥1+). The outcome was incident AF confirmed by 12-lead electrocardiography. The Cox proportional hazard model was used to compute hazard ratio (HR) of proteinuria (≥1+) for incident AF after adjustment for traditional risk factors. We also completed stratified analyses by baseline characteristics. RESULTS: A total of 37,910 participants aged ≥40 years were included (mean age: 72.3 years, male sex: 37%). Proteinuria ≥1+ was observed in 2.765 (7.3%) participants. During a median follow-up period of 5 years, 708 incident AF cases were observed. Proteinuria ≥1+ was associated with incident AF (HR, 1.47: 95% confidence interval, 1.18-1.84) after covariate adjustment. Stratified analysis demonstrated that the association of proteinuria with AF was stronger in participants <75 years [HR 1.89 (95% CI 1.32-2.70)] compared with those ≥75 years [HR 1.27 (95% CI 0.95-1.69)] (interaction p-value=0.02). CONCLUSIONS: Proteinuria was significantly associated with incident AF in the general Japanese population. The evaluation of proteinuria using urine dipstick test may be useful in the evaluation of incident AF, especially in younger general population.
BACKGROUND: Although proteinuria has been associated with incident atrial fibrillation (AF) in Western countries, the association has not been investigated in the general Japanese population. METHODS: Participants aged ≥40 years who underwent the Japanese specific health check-up in Kanazawa City in 2013 and who completed a urine dipstick test were included in this study. Exposure was considered as presence or absence of proteinuria (≥1+). The outcome was incident AF confirmed by 12-lead electrocardiography. The Cox proportional hazard model was used to compute hazard ratio (HR) of proteinuria (≥1+) for incident AF after adjustment for traditional risk factors. We also completed stratified analyses by baseline characteristics. RESULTS: A total of 37,910 participants aged ≥40 years were included (mean age: 72.3 years, male sex: 37%). Proteinuria ≥1+ was observed in 2.765 (7.3%) participants. During a median follow-up period of 5 years, 708 incident AF cases were observed. Proteinuria ≥1+ was associated with incident AF (HR, 1.47: 95% confidence interval, 1.18-1.84) after covariate adjustment. Stratified analysis demonstrated that the association of proteinuria with AF was stronger in participants <75 years [HR 1.89 (95% CI 1.32-2.70)] compared with those ≥75 years [HR 1.27 (95% CI 0.95-1.69)] (interaction p-value=0.02). CONCLUSIONS: Proteinuria was significantly associated with incident AF in the general Japanese population. The evaluation of proteinuria using urine dipstick test may be useful in the evaluation of incident AF, especially in younger general population.
Authors: Alanna M Chamberlain; Sunil K Agarwal; Marietta Ambrose; Aaron R Folsom; Elsayed Z Soliman; Alvaro Alonso Journal: Am Heart J Date: 2010-05 Impact factor: 4.749
Authors: Kunihiro Matsushita; Marije van der Velde; Brad C Astor; Mark Woodward; Andrew S Levey; Paul E de Jong; Josef Coresh; Ron T Gansevoort Journal: Lancet Date: 2010-05-17 Impact factor: 79.321
Authors: Bakhtawar K Mahmoodi; Ron T Gansevoort; Nic J G M Veeger; Abigail G Matthews; Gerjan Navis; Hans L Hillege; Jan van der Meer Journal: JAMA Date: 2009-05-06 Impact factor: 56.272
Authors: Nisha Bansal; Leila R Zelnick; Alvaro Alonso; Emelia J Benjamin; Ian H de Boer; Rajat Deo; Ronit Katz; Bryan Kestenbaum; Jehu Mathew; Cassianne Robinson-Cohen; Mark J Sarnak; Michael G Shlipak; Nona Sotoodehnia; Bessie Young; Susan R Heckbert Journal: Clin J Am Soc Nephrol Date: 2017-08-10 Impact factor: 8.237