Abstract 12632: Non-traditional Risk Factors for Atrial Fibrillation Following Kidney Transplantation
Background: The new onset of atrial fibrillation (AF) in patients following kidney transplant (KTx) may be associated with traditional (TRF) and non-traditional risk factors (NTRF). NTRF may encompass events associated with ESRD and/or transplantation. To address the role of NTRF in new onset AF, we queried the United States Renal Data System (USRDS).
Methods: All adult, first-time KTx cases reported to the USRDS from 2000 to 2008 were queried for a diagnosis of AF, TRF and NTRF. We conducted basic descriptive analyses, as well as Cox proportional hazards regression analysis for outcomes at 1 month, 1year (yr) and 5 yr outcomes post KTx.
Results: 137,336 patients had their first KTx during the study period. Demographics for AF (N=6,447) included: mean age of 59.8 yr, 67.7% male, 71.4% white, and 24.1% African American. The prevalence of hypertension (HTN), coronary artery disease (CAD), hyperthyroidism, coronary artery bypass graft (CABG), congestive heart failure (CHF), and tobacco use in the study population was 71%, 62.4%, 1%, 11.7%, 30.6% and 17.9% respectively. NTRF adjusted for age, white race, male sex, HTN, CAD, hyperthyroidism, CABG, CHF and tobacco use are shown (table). For all time points, preKTx bacteremia (BAC), delayed graft function (DGF), and preKTx dialysis duration of > 5 yrs (Dial>5) were major significant NTRF. Dial>5 had the highest hazard ratio at each time point. The highest risk for these NTRF appear to occur within the first year post KTx.
Conclusion: KTx patients with a history of Dial>5 yrs, preKTx BAC, or DGF may be at increased risk for the development of AF, especially within the first 12 months post-transplant.
- © 2013 by American Heart Association, Inc.