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Worsening Renal Function and Adverse Outcomes in Patients with HFpEF with or without Atrial Fibrillation

Since worsening renal function (WRF) and atrial fibrillation (AF) often coexist in preserved ejection fraction (HFpEF), we aimed to investigate the effect of WRF on the prognosis of HFpEF patients with and without AF. The study population of this study (n = 1763) was based on the subset of the Ameri...

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Autores principales: Guo, Linjuan, Wu, Xiaojuan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10526122/
https://www.ncbi.nlm.nih.gov/pubmed/37760925
http://dx.doi.org/10.3390/biomedicines11092484
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author Guo, Linjuan
Wu, Xiaojuan
author_facet Guo, Linjuan
Wu, Xiaojuan
author_sort Guo, Linjuan
collection PubMed
description Since worsening renal function (WRF) and atrial fibrillation (AF) often coexist in preserved ejection fraction (HFpEF), we aimed to investigate the effect of WRF on the prognosis of HFpEF patients with and without AF. The study population of this study (n = 1763) was based on the subset of the Americas in the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist Trial (TOPCAT). We found that the cumulative probabilities of the primary composite outcome and cardiovascular death were significantly higher in AF patients post-WRF when compared to non-AF patients. In the time-dependent Cox proportional hazard model, WRF was significantly associated with higher risks of adverse outcomes (primary composite outcome: HR = 1.58 (95% CI, 1.19–2.11); all-cause death: HR = 1.50 (95% CI, 1.10–2.06); cardiovascular death: HR, 2.00 (95% CI, 1.34–3.00)) after adjustments for confounding factors at baseline in HFpEF patients with AF, whereas in HFpEF patients without AF, WRF was not significantly associated with any adverse outcome. p for interactions for the primary composite outcome, cardiovascular death, and AF were significant. In conclusion, these findings highlight that WRF was associated with a greater risk of the primary composite outcome, all-cause death, and cardiovascular death in HFpEF patients with AF.
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spelling pubmed-105261222023-09-28 Worsening Renal Function and Adverse Outcomes in Patients with HFpEF with or without Atrial Fibrillation Guo, Linjuan Wu, Xiaojuan Biomedicines Article Since worsening renal function (WRF) and atrial fibrillation (AF) often coexist in preserved ejection fraction (HFpEF), we aimed to investigate the effect of WRF on the prognosis of HFpEF patients with and without AF. The study population of this study (n = 1763) was based on the subset of the Americas in the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist Trial (TOPCAT). We found that the cumulative probabilities of the primary composite outcome and cardiovascular death were significantly higher in AF patients post-WRF when compared to non-AF patients. In the time-dependent Cox proportional hazard model, WRF was significantly associated with higher risks of adverse outcomes (primary composite outcome: HR = 1.58 (95% CI, 1.19–2.11); all-cause death: HR = 1.50 (95% CI, 1.10–2.06); cardiovascular death: HR, 2.00 (95% CI, 1.34–3.00)) after adjustments for confounding factors at baseline in HFpEF patients with AF, whereas in HFpEF patients without AF, WRF was not significantly associated with any adverse outcome. p for interactions for the primary composite outcome, cardiovascular death, and AF were significant. In conclusion, these findings highlight that WRF was associated with a greater risk of the primary composite outcome, all-cause death, and cardiovascular death in HFpEF patients with AF. MDPI 2023-09-07 /pmc/articles/PMC10526122/ /pubmed/37760925 http://dx.doi.org/10.3390/biomedicines11092484 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Guo, Linjuan
Wu, Xiaojuan
Worsening Renal Function and Adverse Outcomes in Patients with HFpEF with or without Atrial Fibrillation
title Worsening Renal Function and Adverse Outcomes in Patients with HFpEF with or without Atrial Fibrillation
title_full Worsening Renal Function and Adverse Outcomes in Patients with HFpEF with or without Atrial Fibrillation
title_fullStr Worsening Renal Function and Adverse Outcomes in Patients with HFpEF with or without Atrial Fibrillation
title_full_unstemmed Worsening Renal Function and Adverse Outcomes in Patients with HFpEF with or without Atrial Fibrillation
title_short Worsening Renal Function and Adverse Outcomes in Patients with HFpEF with or without Atrial Fibrillation
title_sort worsening renal function and adverse outcomes in patients with hfpef with or without atrial fibrillation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10526122/
https://www.ncbi.nlm.nih.gov/pubmed/37760925
http://dx.doi.org/10.3390/biomedicines11092484
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