Key result
Moderate chronic kidney disease independently predicted a higher risk of thromboembolic events in elderly patients with atrial fibrillation (HR 1.63; 95% CI 1.03-2.58).
Why the study?
The study aimed to evaluate the effects of moderate chronic kidney disease and left atrial enlargement on the risks of thromboembolic events, all-cause mortality, and cardiovascular mortality in elderly patients with AF.
Do moderate chronic kidney disease and left atrial enlargement predict thromboembolic events and mortality in elderly patients with atrial fibrillation not on anticoagulation?
Cohort (n=751)
No
Do moderate chronic kidney disease and left atrial enlargement predict thromboembolic events and mortality in elderly patients with atrial fibrillation not on anticoagulation?
Hazard Ratio: 1.63 (95% CI 1.03–2.58)
Moderate CKD and left atrial enlargement are independent predictors of thromboembolic events and mortality in elderly AF patients not receiving anticoagulation.
Supports incorporating moderate CKD into elderly AF risk assessment; leaves open whether it should modify anticoagulation thresholds.
Objective This study aimed to evaluate the effects of moderate chronic kidney disease (CKD) and left atrial enlargement on the risks of thromboembolic events, and all-cause and cardiovascular mortalities in elderly patients with atrial fibrillation (AF). Methods We retrospectively studied 751 patients (82.16% men, mean age: 79.0±9.1 years) with AF who were followed up for an average of 34.5 months at a single center. Adjusted hazard ratios (HRs) of risk factors for adverse clinical events were calculated using the Cox proportional hazards model. Results The risks of thromboembolic events, and all-cause and cardiovascular deaths were higher in patients with moderate CKD compared with patients with normal renal function after adjusting for other traditional risk factors (HR: 1.63, 95% confidence interval (CI): 1.03–2.58; HR: 1.55, 95% CI: 1.08–2.23; HR: 3.49, 95% CI: 1.57–7.74; respectively). Left atrial volume index >28.0 mL/m 2 was an independent risk factor associated with thromboembolic events and all-cause and cardiovascular deaths (HR: 1.62, 95% CI: 1.21–2.33; HR: 1.56, 95% CI: 1.16–2.10; HR: 1.87, 95% CI: 1.07–3.28; respectively). Conclusions Moderate CKD and left atrial enlargement may predict thromboembolic events, and all-cause and cardiovascular mortalities in elderly patients with AF without anticoagulation therapy.
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Wang et al. (2019) conducted a cohort in Atrial fibrillation (n=751). Moderate chronic kidney disease vs. Normal renal function was evaluated on Thromboembolic events (HR 1.63, 95% CI 1.03-2.58). Moderate chronic kidney disease independently predicted a higher risk of thromboembolic events in elderly patients with atrial fibrillation (HR 1.63; 95% CI 1.03-2.58).
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