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Effects of Prevalent and Incident Atrial Fibrillation on Renal Outcome, Cardiovascular Events, and Mortality in Patients with Chronic Kidney Disease
Background: Little is known about how incident atrial fibrillation (AF) affects the clinical outcomes in chronic kidney disease (CKD) patients and whether there is a different influence between pre-existing and incident AF. Methods: Incident CKD patients from 2000 to 2013 were retrieved from the Nat...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780958/ https://www.ncbi.nlm.nih.gov/pubmed/31484322 http://dx.doi.org/10.3390/jcm8091378 |
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author | Hsu, Hsin-Hui Kor, Chew-Teng Hsieh, Yao-Peng Chiu, Ping-Fang |
author_facet | Hsu, Hsin-Hui Kor, Chew-Teng Hsieh, Yao-Peng Chiu, Ping-Fang |
author_sort | Hsu, Hsin-Hui |
collection | PubMed |
description | Background: Little is known about how incident atrial fibrillation (AF) affects the clinical outcomes in chronic kidney disease (CKD) patients and whether there is a different influence between pre-existing and incident AF. Methods: Incident CKD patients from 2000 to 2013 were retrieved from the National Health Insurance Research Database (NHIRD) of Taiwan and they were classified as non-AF (n = 15,251), prevalent AF (n = 612), and incident AF (n = 588). The outcomes of interest were end-stage renal disease (ESRD) requiring dialysis, all-cause mortality, cardiovascular (CV) mortality, acute myocardial infarction (AMI), stroke or systemic thromboembolism. Results: Compared with CKD patients without AF, those with prevalent or incident AF were associated with higher adjusted rates of ESRD (hazard ratio (HR), 1.40; 95% confidence interval (CI), 1.32–1.48; HR, 2.91; 95% CI, 2.74–3.09, respectively), stroke or systemic thromboembolism (HR, 1.89; 95% CI, 1.77–2.03; HR, 1.67; 95% CI, 1.54–1.81, respectively), AMI (HR, 1.24; 95% CI, 1.09–1.41; HR, 1.99; 95% CI, 1.75–2.27, respectively), all-cause mortality (HR, 1.64; 95% CI, 1.56–1.72; HR, 2.17; 95% CI, 2.06–2.29, respectively), and CV mortality (HR, 2.95; 95% CI, 2.62–3.32; HR, 4.61; 95% CI, 4.09–5.20, respectively). Intriguingly, CKD patients with prevalent AF were associated with lower adjusted rates of ESRD, AMI, all-cause mortality, and CV mortality compared with those with incident AF. Conclusion: Both incident and prevalent AF were independently associated with greater risks of AMI, all-cause mortality, CV mortality, ESRD, and stroke or systemic thromboembolism. Our findings are novel in that, compared with prevalent AF, incident AF possessed an even higher risk of some clinical consequences, including ESRD, all-cause mortality, CV mortality, and AMI. |
format | Online Article Text |
id | pubmed-6780958 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-67809582019-10-30 Effects of Prevalent and Incident Atrial Fibrillation on Renal Outcome, Cardiovascular Events, and Mortality in Patients with Chronic Kidney Disease Hsu, Hsin-Hui Kor, Chew-Teng Hsieh, Yao-Peng Chiu, Ping-Fang J Clin Med Article Background: Little is known about how incident atrial fibrillation (AF) affects the clinical outcomes in chronic kidney disease (CKD) patients and whether there is a different influence between pre-existing and incident AF. Methods: Incident CKD patients from 2000 to 2013 were retrieved from the National Health Insurance Research Database (NHIRD) of Taiwan and they were classified as non-AF (n = 15,251), prevalent AF (n = 612), and incident AF (n = 588). The outcomes of interest were end-stage renal disease (ESRD) requiring dialysis, all-cause mortality, cardiovascular (CV) mortality, acute myocardial infarction (AMI), stroke or systemic thromboembolism. Results: Compared with CKD patients without AF, those with prevalent or incident AF were associated with higher adjusted rates of ESRD (hazard ratio (HR), 1.40; 95% confidence interval (CI), 1.32–1.48; HR, 2.91; 95% CI, 2.74–3.09, respectively), stroke or systemic thromboembolism (HR, 1.89; 95% CI, 1.77–2.03; HR, 1.67; 95% CI, 1.54–1.81, respectively), AMI (HR, 1.24; 95% CI, 1.09–1.41; HR, 1.99; 95% CI, 1.75–2.27, respectively), all-cause mortality (HR, 1.64; 95% CI, 1.56–1.72; HR, 2.17; 95% CI, 2.06–2.29, respectively), and CV mortality (HR, 2.95; 95% CI, 2.62–3.32; HR, 4.61; 95% CI, 4.09–5.20, respectively). Intriguingly, CKD patients with prevalent AF were associated with lower adjusted rates of ESRD, AMI, all-cause mortality, and CV mortality compared with those with incident AF. Conclusion: Both incident and prevalent AF were independently associated with greater risks of AMI, all-cause mortality, CV mortality, ESRD, and stroke or systemic thromboembolism. Our findings are novel in that, compared with prevalent AF, incident AF possessed an even higher risk of some clinical consequences, including ESRD, all-cause mortality, CV mortality, and AMI. MDPI 2019-09-03 /pmc/articles/PMC6780958/ /pubmed/31484322 http://dx.doi.org/10.3390/jcm8091378 Text en © 2019 by the authors. 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 (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Hsu, Hsin-Hui Kor, Chew-Teng Hsieh, Yao-Peng Chiu, Ping-Fang Effects of Prevalent and Incident Atrial Fibrillation on Renal Outcome, Cardiovascular Events, and Mortality in Patients with Chronic Kidney Disease |
title | Effects of Prevalent and Incident Atrial Fibrillation on Renal Outcome, Cardiovascular Events, and Mortality in Patients with Chronic Kidney Disease |
title_full | Effects of Prevalent and Incident Atrial Fibrillation on Renal Outcome, Cardiovascular Events, and Mortality in Patients with Chronic Kidney Disease |
title_fullStr | Effects of Prevalent and Incident Atrial Fibrillation on Renal Outcome, Cardiovascular Events, and Mortality in Patients with Chronic Kidney Disease |
title_full_unstemmed | Effects of Prevalent and Incident Atrial Fibrillation on Renal Outcome, Cardiovascular Events, and Mortality in Patients with Chronic Kidney Disease |
title_short | Effects of Prevalent and Incident Atrial Fibrillation on Renal Outcome, Cardiovascular Events, and Mortality in Patients with Chronic Kidney Disease |
title_sort | effects of prevalent and incident atrial fibrillation on renal outcome, cardiovascular events, and mortality in patients with chronic kidney disease |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780958/ https://www.ncbi.nlm.nih.gov/pubmed/31484322 http://dx.doi.org/10.3390/jcm8091378 |
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