Abstract 18013: Impact of Chronic Kidney Disease on Risk of Incident Atrial Fibrillation and Subsequent Survival in Medicare Patients
Introduction: Atrial Fibrillation (AF) is common in elderly pts and its prevalence increased in pts with chronic kidney disease (CKD). Few studies have examined CKD as a risk factor for incident AF in elderly pts.
Methods: We identified 1,094,137 pts (age 66+) prevalent on 12/31/06 in the 5% General Medicare database (prior AF and ESRD excluded) and followed through 12/31/08. CKD stage was identified from ICD-9 codes 585.1-585.5, 585.9. The risk of developing AF and subsequent mortality was assessed, separately, in a Cox model adjusting for demographics, and comorbidity. Unadjusted survival after incident AF was estimated by Kaplan-Meier method.
Results: The prevalent 2006 cohort was 41% male, 88% white, 23% age 66-69, 25% age 70-74, 21% age 75-79, 16% age 80-84, and 14% age 85+. By CKD stage: 94.9% no CKD, 0.5% stage I-II, 1.8% stage III-V, 2.9% stage unknown. By CKD stage incident AF occurred in 6.9% no CKD, 10.8% stage I-II, 12.2% stage III-V, 11.5% stage unknown. The Table shows predictors of AF and subsequent mortality (age 66-69, male, white, no CKD, no comorbid conditions is reference) with hazard ratio (HR) and survival of AF pts.
Conclusion: CKD stage is a predictor of incident AF and subsequent risk of death in elderly pts. Medicare pts with CKD and AF have a high (>30%) one year mortality.
- © 2010 by American Heart Association, Inc.