Abstract P103: Kidney Function and Sudden Cardiac Death in the Community: The Atherosclerosis Risk in Communities (ARIC) Study
Introduction: Individuals with chronic kidney disease (CKD), particularly those requiring dialysis, are at high risk of sudden cardiac death (SCD). However, data for the full-spectrum of kidney function and SCD risk in the community are sparse. Furthermore, newly developed equations for estimated glomerular filtration rate (eGFR) and novel filtration markers might add further insight to the role of kidney function in SCD.
Methods: We investigated the associations of baseline eGFRs using either serum creatinine, cystatin C (CysC), or both (eGFRcr, eGFRcr-cys, and eGFRcys), CysC itself, and β2-microglobulin (B2M) with SCD through 2001 among 13,070 blacks and whites participants at the second visit (1990-92) of the community-based ARIC Study. Cox regression models were used to quantify the associations of kidney function and different markers of kidney filtration with SCD after the adjustment for potential confounders. The cohort was divided into 5 groups based on clinical CKD Stages as well as quartiles.
Results: Over a median of 11 years of follow-up, 205 participants developed SCD (1.4 cases per 1000 person-years). Low eGFR was independently associated with SCD risk: for example, HR for eGFR 30-44 vs ≥90 ml/min/1.73m2 was 3.97 (95%CI 1.57-10.03) with eGFRcr; HR 6.96 (3.56-13.61) with eGFRcr-cys; and HR 5.47 (2.97-10.09) with eGFRcys. Of note, when eGFRcr and eGFRcys were included together in a single model, the association was only significant for eGFRcys. When we compared all kidney markers based on their quartiles, B2M demonstrated the strongest association with SCD (Table). Qualitatively consistent results were observed across clinical and demographic subgroups.
Conclusion: Kidney function was independently and robustly associated with SCD in the community, particularly when CysC or B2M were taken into account as filtration markers. These results may suggest the importance of kidney function for SCD risk evaluation and the value of novel filtration markers beyond eGFRcr in association with SCD.
Author Disclosures: T. Suzuki: None. S.K. Agarwal: None. R. Deo: None. N. Sotoodehnia: None. M. Grams: None. E. Selvin: None. H. Calkins: None. W. Rosamond: None. G. Tomaselli: None. J. Coresh: None. K. Matsushita: None.
- © 2015 by American Heart Association, Inc.