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

Corrao, Salvatore; Argano, Christiano; Nobili, Alessandro; Marcucci, Maura; Djade, Codjo D.; Tettamanti, Mauro; Pasina, Luca; Franchi, Carlotta; Marengoni, Alessandra; Salerno, Francesco; Violi, Francesco; Mannucci, Pier Mannuccio; Perticone, Francesco

doi:10.1016/j.ejim.2015.02.018

Cited by 12 publications

(15 citation statements)

References 46 publications

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“…Atrial fibrillation (AF) is a common cardiac arrhythmia with a high prevalence in the elderly population, typically associated with arterial hypertension and chronic kidney disease (CKD) [7] as…”

Section: Accepted Manuscript Introductionmentioning

confidence: 99%

Aspirin and renal insufficiency progression in patients with atrial fibrillation and chronic kidney disease

Pastori

Pignatelli

Perticone

et al. 2016

International Journal of Cardiology

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Section: Accepted Manuscript Introductionmentioning

confidence: 99%

Aspirin and renal insufficiency progression in patients with atrial fibrillation and chronic kidney disease

Pastori

Pignatelli

Perticone

et al. 2016

International Journal of Cardiology

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“…The presence of CKD is a known risk factor for AKI; however, this relationship is difficult to assess due to the presence of many confounders [ 42 ]. Micro-thromboembolism has been postulated to play a role in CKD and cognitive decline [ 43 ]. It may also be relevant for AKI.…”

Section: Discussionmentioning

confidence: 99%

Atrial Fibrillation and Chronic Kidney Disease—A Risky Combination for Post-Contrast Acute Kidney Injury

Kuźma

Tomaszuk‐Kazberuk

Kurasz

et al. 2021

JCM

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Atrial fibrillation (AF) symptoms may mimic coronary artery disease (CAD) which reflects the difficulties in qualifying AF patients for invasive diagnostics. A substantial number of coronary angiographies may be unnecessary or even put patients at risk of post-contrast acute kidney injury (PC-AKI), especially patients with chronic kidney disease (CKD). We aimed to investigate the hypothesis indicating higher prevalence of PC-AKI in patients with AF scheduled for coronary angiography. The study population comprised of 8026 patients referred for elective coronarography including 1621 with AF. In the comparison of prevalence of PC-AKI in distinguished groups we can see that kidney impairment was twice more frequent in patients with AF in both groups with CKD (CKD (+)/AF (+) 6.24% vs. CKD (+)/AF (−) 3.04%) and without CKD (CKD (−)/AF (+) 2.32% vs. CKD (−)/AF (−) 1.22%). In our study, post-contrast acute kidney disease is twice more frequent in patients with AF, especially in subgroup with chronic kidney disease scheduled for coronary angiography. Additionally, having in mind results of previous studies stating that AF is associated with non-obstructive coronary lesions on angiography, patients with AF and CKD may be unnecessarily exposed to contrast agent and possible complications.

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“…Micro-thromboembolism has been postulated to play a role in cognitive decline and CKD post-DCCV. Similar mechanisms may play a role in AKI [30]. These potential mechanisms are merely speculative based on observational data and require additional studies.…”

Section: Discussionmentioning

confidence: 99%

Renal Dysfunction following Direct Current Cardioversion of Atrial Fibrillation: Incidence and Risk Factors

et al. 2020

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Introduction: Emerging data suggest that cardioversion for atrial fibrillation (AF) may be associated with acute kidney injury (AKI). However, limited data are available regarding the incidence and risk factors for AKI after direct current cardioversion (DCCV) of AF. Methods: All patients undergoing DCCV at Mayo Clinic between 2001 and 2012 for AF were prospectively enrolled in a database. All patients with serum creatinine (SCR) values pre- and post-cardioversion were reviewed for AKI, defined as a ≥25% decline in eGFR (estimated glomerular filtration rate) from baseline value within 7 days of the DCCV. Results: Of the 6,427 eligible patients, 1,256 (19.5%) patients had pre- and post-DCCV SCR available and formed the cohort under study. The mean age was 70.4 (SD 11.7) years, and 67.3% were male. During the study period, 131 (10.4%) patients suffered from AKI following DCCV. AKI was independently associated with inpatient status (OR 26.79; 95% CI 3.69–194.52), CHA2DS2-VASc score (OR 1.25; 95% CI 1.11–1.41), prior use of diuretics (OR 1.59; 95% CI 1.03–2.46), and absence of CKD (OR 1.61; 95% CI 1.04–2.49), and was independent of the success of the DCCV. None of the patients required acute dialysis during the study outcome period. Conclusion: AKI following DCCV of AF is common, self-limited, and without the need for replacement therapies.

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

Cited by 12 publications

References 46 publications

Aspirin and renal insufficiency progression in patients with atrial fibrillation and chronic kidney disease

Aspirin and renal insufficiency progression in patients with atrial fibrillation and chronic kidney disease

Atrial Fibrillation and Chronic Kidney Disease—A Risky Combination for Post-Contrast Acute Kidney Injury

Renal Dysfunction following Direct Current Cardioversion of Atrial Fibrillation: Incidence and Risk Factors

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