A prospective study of estimated glomerular filtration rate and outcomes in patients with atrial fibrillation: The Loire Valley Atrial Fibrillation Project

Banerjee, Amal; Halimi, Jean Michel; Vourc’h, Patrick; Andres, Claudia; Taillandier, Sophie; Lip, G Y H; Fauchier, Laurent

doi:10.1093/eurheartj/eht310.p5614

Cited by 29 publications

(57 citation statements)

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“…We also report an increased risk of all-cause death among those with AF and CKD. These results are consistent with prior reports noting similar associations [8,[15][16][17]. We were specifically interested in cause-specific mortality in this population with both AF and CKD and found that cardiovascular deaths accounted for approximately half of the deaths.…”

Section: Discussionsupporting

confidence: 92%

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Cause-Specific Mortality in Patients with Chronic Kidney Disease and Atrial Fibrillation

et al. 2018

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Background: Atrial fibrillation (AF) is associated with death in patients with chronic kidney disease (CKD). We examined the associations between AF and cause-specific mortality in a large CKD population. Methods: We included 62,459 patients with estimated glomerular filtration rate 15–59 mL/min/1.73 m² (6,639 patients with AF and 55,820 without AF) followed in a large health care system. Outcomes included overall and cause-specific deaths (a) cardiovascular; (b) malignancy; and (c) non-cardiovascular/non-malignancy causes. Cox regression models for overall mortality and separate competing risk models for each major cause of death category were used to evaluate their respective associations with AF. Results: During a median follow-up of 4.1 years, 19,094 patients died; cause of death was known for 18,854 patients. After multivariable adjustment (demographics, comorbidities, relevant laboratory data, medication use, and kidney function), AF was associated with 23% (95% CI 18–29%) higher risk of all-cause mortality, 45% (95% CI 31–61%) higher risk of cardiovascular mortality and 13% (95% CI 3–22%) lower risk of malignancy-related mortality. Exclusion of patients with malignancy yielded similar results except for a lack of association between AF and malignancy-related deaths. Results were consistent across various stages of CKD. Conclusions: In a non-dialysis-dependent CKD population, the presence of AF was associated with higher all-cause and cardiovascular mortality. These data suggest that patients with both CKD and AF are at high cardiovascular risk, and thus clinical practice (or trials) should aim at reducing the overall excess cardiovascular mortality (not stroke alone) in patients with AF and CKD.

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Section: Discussionsupporting

confidence: 92%

“…AF is associated with a higher all-cause mortality among patients with ESRD [2,14], as has been shown among patients with non-dialysis-dependent CKD [8,[15][16][17]. However, less is known about the potential reasons for the increased mortality risk associated with AF.…”

Section: Introductionmentioning

confidence: 99%

Cause-Specific Mortality in Patients with Chronic Kidney Disease and Atrial Fibrillation

et al. 2018

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“…On the other hand, the overall underuse of anticoagulants that we recorded may be very dangerous. In patients with CKD, this is very important since, among patients with non-valvular AF, patients with renal failure not on OAC therapy have a four-fold greater risk of mortality than those with normal renal function [12].…”

Section: Discussionmentioning

confidence: 99%

“…We subdivided patients with AF according to cognitive status: without CI (SBT score 0-4), moderate CI (SBT score 5-9), and severe CI (SBT score [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. In these subsets of the population, we analyzed the available information on socio-demographic and clinical characteristics; length of hospital stay; in-hospital and 3-month mortality rates; and antithrombotic therapy at admission, discharge, and at 3-month followup.…”

Section: Cognitive Status and Anticoagulant Therapymentioning

confidence: 99%

“…On the other hand, it is well known that chronic kidney disease (CKD) patients are at higher risk for ischemic stroke/cardiogenic cerebral embolism, with the risk increasing parallel to the fall in estimated glomerular filtration rate (eGFR) [12][13][14]. CKD is, in fact, an important predictor of stroke among patients with non-valvular AF [15,16].…”

Section: Introductionmentioning

confidence: 99%

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Brain and kidney, victims of atrial microembolism in elderly hospitalized patients? Data from the REPOSI study

Corrao

Argano

Nobili

et al. 2015

European Journal of Internal Medicine

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Glomerular filtration rate: A prognostic marker in atrial fibrillation—A subanalysis of the AntiThrombotic Agents Atrial Fibrillation

Proietti

Gonzini

Pizzimenti

et al. 2018

Clinical Cardiology

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A prospective study of estimated glomerular filtration rate and outcomes in patients with atrial fibrillation: The Loire Valley Atrial Fibrillation Project

Cited by 29 publications

References 0 publications

Cause-Specific Mortality in Patients with Chronic Kidney Disease and Atrial Fibrillation

Cause-Specific Mortality in Patients with Chronic Kidney Disease and Atrial Fibrillation

Brain and kidney, victims of atrial microembolism in elderly hospitalized patients? Data from the REPOSI study

Glomerular filtration rate: A prognostic marker in atrial fibrillation—A subanalysis of the AntiThrombotic Agents Atrial Fibrillation

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