Abstract 13956: Cystatin C Based Estimated Glomerular Filtration Rate is a Feasible Parameter for Incident Stroke in Patients With Atrial Fibrillation
Introduction: Chronic kidney disease (CKD) is an important risk factor of stroke in patients with atrial fibrillation (AF). Since AF patients with high CHADS2 score are likely to be old and have history of TIA or stroke, there could be patients who have sarcopenia. Cystatin C based estimated glomerular filtrarion rate (eGFRcys) is less affected by age, gender and muscle mass compared to creatine based eGFR (eGFRcr). We investigated whether eGFRcys is more closely associated with incident stroke in AF patients compared to eGFRcr.
Methods: We performed transthoracic and transesophageal echocardiography and measured eGFRcys and eGFRcr in 349 patients with paroxysmal AF and chronic AF (256 males, 64.4 ± 11.7 years). We excluded those who had severe valvular heart disease and end stage renal desease. There were 42 patients with stroke history.
Results: eGFRcys showed better correlation with left atrial volume index, levels of brain natriuretic peptide, von Willebrand factor, and left atrial appendage emptying flow velocity, than eGFRcr. eGFRcys was decreased with increading CHADS2 and CHA2DS2VASc score. Patients with left atrial appendage and/or spontaneous echo contrast had a significantly lower eGFRcys compared to those without. The proportion of patients with stroke was increased with advancing CKD stage in eGFRcys. Although eGFRcys and eGFRcr were associated with stroke in logistic regression analysis, eGFRcys but not eGFRcr was an independent predictor for stroke after adjustment for CHADS2 score.
Conclusion: eGFRcys is a feasible parameter for incident stroke in AF patients.
Author Disclosures: N. Hashimoto: None. S. Nishiyama: None. T. Watanabe: None. M. Wanezaki: None. G. Yamaura: None. T. Arimoto: None. H. Takahashi: None. T. Shishido: None. T. Miyamoto: None. I. Kubota: None.
- © 2015 by American Heart Association, Inc.