Abstract 14487: Chronic Kidney Disease as a Predictor of Atrial Fibrillation in Treated Hypertensive Patients: A 4-Year Prospective Study
Introduction: The association of impaired kidney function with incidence of atrial fibrillation (AF) is still unclear.
Hypothesis: We investigated the predictive value of chronic kidney disease (CKD) for the development of AF in treated hypertensive patients.
Methods: We followed 1651 treated hypertensive patients (47% males, aged 57±11 years) without a history of cardiovascular disease or AF episodes for a mean period of 3.9 years. At baseline, clinical data were collected, and transthoracic echocardiography and electrocardiography and routine blood testing were performed. Glomerular filtration rate (eGFR) was estimated with the Modification of Diet in Renal Disease equation and CKD was defined as an eGFR<60ml/min/1.73m2. Endpoint of interest was new-onset AF defined as hospitalization for AF or compatible ECG tracings. In case of multiple episodes of AF, only the first was recorded as an event
Results: There were 48 cases of AF documented during follow-up. Patients with AF were older (by 9,1 years, p<0.001), had a larger waist (by 4.13cm, p=0.017), longer-standing hypertension (by 3.43 years, p=0.011), a larger left ventricular mass index (LVMI) (by 13.4g/m2, p=0.001) and left atrial diameter (by 4.0mm, p<0.001) and a lower eGFR (by 5.6ml/min/1.73m2, p=0.034). Unadjusted analysis revealed that CKD was associated with a higher risk of 1.99 (CI:1.02-3.90, p=0.045) for development of AF. However, this risk was attenuated and non-significant after controlling for established clinical and echocardiographic risk factors for AF.
Conclusions: In treated hypertensive patients, CKD is associated with an almost double risk for new-onset AF, but this risk is non-significant after adjusting for other AF risk predictors.
- © 2013 by American Heart Association, Inc.