Relation of Atrial Fibrillation to Glomerular Filtration Rate

Iguchi, Yasuyuki; Kimura, Kazumi; Kobayashi, Kazuto; Aoki, Junya; Terasawa, Yuka; Sakai, Kenichiro; Uemura, Junichi; Shibazaki, Kensaku

doi:10.1016/j.amjcard.2008.06.018

Cited by 108 publications

(89 citation statements)

References 16 publications

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“…5 A recent study performed in Japan further demonstrated that the prevalence of AF gradually increased with a decreasing GFR, which was unrelated to the age increases. 4 The findings of these previous studies suggest that processes influencing the development of AF likely occur early in the course of the decline in the GFR.…”

Section: Renal Function Atrial Substrate Properties and Afmentioning

confidence: 91%

Associations Between Renal Function, Atrial Substrate Properties and Outcome of Catheter Ablation in Patients With Paroxysmal Atrial Fibrillation

Chao

Lin

Chang

et al. 2011

Circ J

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Background: Renal dysfunction was reported to be associated with a higher recurrence rate after electric cardioversion of atrial fibrillation (AF). The aim of this study was to investigate the associations between renal function, atrial substrate properties and outcome of catheter ablation in paroxysmal AF patients. Methods and Results:A total of 232 paroxysmal AF patients that underwent catheter ablation were enrolled in the study. The estimated glomerular filtration rate (GFR) was calculated using the Cockcroft-Gaut equation normalized by the body surface area, and the patients were divided into 3 groups according to their GFR (group 1: ≥90 ml · min -1 · 1.73 m -2 , group 2: 60-90 ml · min -1 · 1.73 m -2 and group 3: <60 ml · min -1 · 1.73 m -2 ). The left atrial (LA) voltage became lower and the activation time longer when the GFR decreased from group 1 to group 3. During a follow up of 25.4±13.3 months, 15.9% of the study population suffered from AF recurrences. The recurrence rates of those 3 groups were 6.9%, 14.5% and 38.9%, respectively. The LA dimension, LA voltage and groups of renal function were identified to be the independent predictors of an AF recurrence in the multivariate analysis. Conclusions:A decreased GFR was associated with an abnormal LA substrate and high recurrence rate of catheter ablation in patients with paroxysmal AF. (Circ J 2011; 75: 2326 - 2332

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Section: Renal Function Atrial Substrate Properties and Afmentioning

confidence: 91%

Associations Between Renal Function, Atrial Substrate Properties and Outcome of Catheter Ablation in Patients With Paroxysmal Atrial Fibrillation

Chao

Lin

Chang

et al. 2011

Circ J

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“…Several clinical and population-based studies have shown that the prevalence of AF is independently associated with decreased eGFR and increased levels of urinary albumin (11)(12)(13). A recent study reported that decreased eGFR is associated with an increased risk of subsequent new onset AF in a large scale of community-based cohort (14).…”

Section: Discussionmentioning

confidence: 99%

Impact of Decreased Estimated Glomerular Filtration Rate on Japanese Acute Stroke and Its Subtype

et al. 2012

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Objective Patients with chronic kidney disease (CKD) are at a high risk for cardiovascular diseases including stroke. However, the characteristics of the stroke subtypes in patients with CKD remain to be determined. Methods We investigated the associations between stroke subtypes and estimated glomerular filtration rate (eGFR), and traditional risk factors in 451 (males, 239; mean age, 71.1 y) acute stroke patients at our hospital between 2006 and 2010. Results The stroke subtype was cardiogenic cerebral embolism in 129 (29%), cerebral hemorrhage in 104 (23%), unclassified cerebral infarction in 65 (14%), lacunar infarction in 65 (14%), subarachnoid hemorrhage in 41 (9%), atherothrombosis in 30 (7%), and transient ischemic attacks in 17 (4%). Among the 451 patients, 134 (30%) had CKD with eGFR <60 mL/min/1.73 m 2 . Compared with a group without CKD, mean age (75.9 vs. 69.0 years, p<0.05), the prevalence of atrial fibrillation (AF) (44% vs. 21%, p<0.01) and a history of cardiovascular disease (37% vs. 19%, p<0.01) were significantly higher in that with CKD. A comparison of stroke subtypes revealed a significantly higher incidence of cardiogenic cerebral embolism (36% vs. 26%, p<0.05) in the group with, than without CKD. Conclusion We showed the prevalence of CKD in about 30% of acute stroke patients, and those patients were older, had a significantly higher prevalence of AF and a higher rate of cardiogenic cerebral embolism compared with patients without CKD. Thus, strict control of blood pressure and management of AF should be important to prevent stroke among patients with CKD.

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“…128 However, patients with stage 4 to 5 CKD are known to be at increased risk for atrial fibrillation owing to structural and electric atrial remodeling. 131,132 In the Rivaroxaban Once-Daily Oral Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET-AF), Ͼ14 000 patients with atrial fibrillation were randomized to 20 mg rivaroxaban once daily (or 15 mg in patients with moderate renal impairment at screening) or to dose-adjusted warfarin (titrated to an international normalized ratio of 2.5). Rivaroxaban was found to be noninferior to warfarin in terms of the combined primary end point of stroke and systemic embolisms and was superior to warfarin in the on-treatment but not in the stricter intention-to-treat analysis, raising concerns about potentially poor adherence with rivaroxaban in real-world practice.…”

Section: Impact Of Antithrombotic Therapies In Ckd Patients With Atrimentioning

confidence: 99%

Antithrombotic Therapy in Patients With Chronic Kidney Disease

2012

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Relation of Atrial Fibrillation to Glomerular Filtration Rate

Cited by 108 publications

References 16 publications

Associations Between Renal Function, Atrial Substrate Properties and Outcome of Catheter Ablation in Patients With Paroxysmal Atrial Fibrillation

Associations Between Renal Function, Atrial Substrate Properties and Outcome of Catheter Ablation in Patients With Paroxysmal Atrial Fibrillation

Impact of Decreased Estimated Glomerular Filtration Rate on Japanese Acute Stroke and Its Subtype

Antithrombotic Therapy in Patients With Chronic Kidney Disease

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