Abstract 14514: Moderate-to-Severe Chronic Kidney Disease Associated With 1-Year All-Cause Mortality in Patients Newly Diagnosed With Non-Valvular Atrial Fibrillation. The Prospective International GARFIELD Registry
Hypothesis: We assessed the hypothesis that degree of chronic kidney disease (CKD) would impact cardiovascular outcomes in patients newly diagnosed with non-valvular atrial fibrillation (AF).
Methods: Between December 2009 and October 2011, 10,614 patients with newly diagnosed non-valvular AF and ≥1 additional investigator-defined stroke risk factor (not restricted to those in existing risk scores) were recruited consecutively at 540 sites in 19 countries. The effect of CKD (according to the NKF-KDOQI classification) on cardiovascular outcomes at 1 year was investigated in the 5525 patients enrolled prospectively, using a Cox proportional hazards model, adjusting for use of antithrombotic treatments at AF diagnosis and components of the CHA2DS2-VASc risk score.
Results: Of the 5525 patients, 3990 had data on renal function; outcomes at 1 year after AF diagnosis were available in 3763 of 3990 (94%). Patients with stage 3 or 4 CKD (n=474, 12%) were on average older than those with stages 2 (n=793, 20%) or 1 CKD (n=2723, 68%) (mean±standard deviation of 77±9 vs 71±10 and 69±12 years, respectively; p<0.001); more often female (51% vs 43% and 43%, p=0.005); and on average had higher CHADS2 (2.6±1.2, 2.0±1.1, 1.8±1.1; p<0.001), CHA2DS2-VASc (4.3±1.5, 3.4±1.5, 3.0±1.6; p<0.001) and HAS-BLED (2.2±0.6, 1.0±0.6, 0.8±0.7; p<0.001) scores. After adjustment, stage 3/4 CKD was associated with a higher risk of death at 1 year (Table).
Conclusion: These observational data from the ongoing GARFIELD Registry support the hypothesis that moderate-to-severe CKD is associated with increased 1-year mortality in patients with newly diagnosed AF.
- © 2013 by American Heart Association, Inc.