Impaired Kidney Function and Atrial Fibrillation in Elderly Subjects

被引:45
作者
Deo, Rajat [1 ]
Katz, Ronit
Kestenbaum, Bryan [2 ]
Fried, Linda [3 ,4 ]
Sarnak, Mark J. [5 ]
Psaty, Bruce M. [6 ]
Siscovick, David S. [6 ]
Shlipak, Michael G. [7 ,8 ,9 ,10 ]
机构
[1] Univ Penn, Div Cardiol, Philadelphia, PA 19104 USA
[2] Univ Washington, Dept Med, Div Nephrol, Seattle, WA 98195 USA
[3] Univ Pittsburgh, Sch Med, Renal Electrolyte Div, Pittsburgh, PA USA
[4] VA Pittsburgh Healthcare Syst, Renal Sect, Pittsburgh, PA USA
[5] Tufts Univ New England Med Ctr, Dept Internal Med, Div Nephrol, Boston, MA USA
[6] Univ Washington, Cardiovasc Hlth Res Unit, Seattle, WA USA
[7] Vet Affairs Med Ctr, Gen Internal Med Sect, San Francisco, CA 94121 USA
[8] Univ Calif San Francisco, Dept Med, San Francisco, CA USA
[9] Univ Calif San Francisco, Dept Epidemiol, San Francisco, CA USA
[10] Univ Calif San Francisco, Dept Biostat, San Francisco, CA USA
关键词
Kidney function; cystatin C; arrhythmias; elderly; epidemiology; LEFT-VENTRICULAR DYSFUNCTION; CYSTATIN-C; RISK-FACTORS; CARDIOVASCULAR-DISEASE; HEART-FAILURE; SINUS RHYTHM; HEALTH; ALDOSTERONE; MORTALITY; ENALAPRIL;
D O I
10.1016/j.cardfail.2009.07.002
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Impaired kidney function is associated with increased risk for cardiovascular events. We evaluated whether kidney function is associated with atrial fibrillation (AF) risk in elderly persons. Methods and Results: Subjects were participants in the Cardiovascular Health Study (CHS), a population-based cohort of ambulatory elderly. Measures of kidney function were cystatin C and creatinine-based estimated glomerular filtration rate (eGFR). Among the 4663 participants, 342 (7%) had AF at baseline and 579 (13%) developed incident AF during follow-up (mean 7.4 years). In unadjusted analyses, cystatin C quartiles were strongly associated with prevalent AF with a nearly 3-fold odds in the highest quartile compared with the lowest (HR = 1.19, 95% CI [0.80-1.76] in quartile 2; FIR = 2.00, 95% Cl [1.38-2.88] in quartile 3; and FIR = 2.87, 95% Cl [2.03-4.07] in quartile 4). This increased risk for prevalent AF remained significant after multivariate adjustment. The risk for incident AF increased across cystatin C quartiles in the unadjusted analysis (HR = 1.37, 95% Cl [1.07-1.75] in quartile 2; HR = 1.43, 95% CI [1.11-1.84] in quartile 3; and HR = 1.88, 95% Cl [1.47-2.41] in quartile 4); however, after multivariate adjustment, these findings were no longer significant. An estimated GFR <60 mL . min . 1.73 m(2) was associated with prevalent and incident AF in unadjusted, but not multivariate analyses. Conclusions: Impaired kidney function, as measured by cystatin C, is an independent marker of prevalent AF; however, neither cystatin C nor eGFR are predictors of incident AF. (J Cardiac Fail 2010:16:55-60)
引用
收藏
页码:55 / 60
页数:6
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