OBJECTIVE: An increased cardiovascular mortality and morbidity has been widely reported in patients with atrial fibrillation (AF). In this study, a subanalysis of the AntiThrombotic Agents Atrial Fibrillation (ATA-AF) is performed with the aim to evaluate estimated glomerular filtration rate (eGFR) as an independent prognostic marker of cardiovascular mortality and morbidity in patients with AF. METHODS AND RESULTS: The ATA-AF study enrolled 7148 patients with AF, in 360 Italian centers. The eGFR was calculated from data reported in patient notes or hospital database. This post-hoc analysis included 1097 AF patients with eGFR data available and 1-year clinical follow-up. The endpoint was assessed as cardiovascular mortality and/or hospital admission for cardiovascular causes at follow-up. Patients were also divided in two groups according to the eGFR (<60 and ≥60 mL/min/1.73 m2 ). The Kaplan-Meyer curve for the mentioned endpoint showed a higher endpoint incidence in the group of patient with eGFR below 60 mL/min/1.73 m2 (P < 0.001). Using multivariate analysis (Cox regression), a trend toward a higher rate of occurrence of the primary endpoint was observed for eGFR below 60 mL/min/1.73 m2 without reaching the conventional level of statistical significance (hazard ratio [HR] 1.40; 95% confidence interval [CI] 0.99-1.99; P = 0.0572). When eGFR was included in the analysis as continuous variable a significant correlation was observed with the combined endpoint at the Cox regression (HR 0.99, 95% CI 0.98-0.99, P = 0.04). CONCLUSION: The result of this post-hoc analysis indicates that an impaired eGFR is independently associated with worse prognosis among patients with AF.

Glomerular filtration rate: A prognostic marker in atrial fibrillation-A subanalysis of the AntiThrombotic Agents Atrial Fibrillation

Sicuro, M.
Membro del Collaboration Group
;
Lenti, S.
Membro del Collaboration Group
;
Bianchi, V.
Membro del Collaboration Group
;
Lo Sciuto, A.
Membro del Collaboration Group
;
Elia, M.
Membro del Collaboration Group
;
Mazzone, A.
Membro del Collaboration Group
;
Donà, G.
Membro del Collaboration Group
;
Barbieri, E.
Membro del Collaboration Group
;
Sanna, P.
Membro del Collaboration Group
;
Pellegrini, F.
Membro del Collaboration Group
;
Lazzarini, D.
Membro del Collaboration Group
;
Sinagra, G.
Membro del Collaboration Group
;
De Biasio, M.
Membro del Collaboration Group
;
Proclemer, A.
Membro del Collaboration Group
;
2018-01-01

Abstract

OBJECTIVE: An increased cardiovascular mortality and morbidity has been widely reported in patients with atrial fibrillation (AF). In this study, a subanalysis of the AntiThrombotic Agents Atrial Fibrillation (ATA-AF) is performed with the aim to evaluate estimated glomerular filtration rate (eGFR) as an independent prognostic marker of cardiovascular mortality and morbidity in patients with AF. METHODS AND RESULTS: The ATA-AF study enrolled 7148 patients with AF, in 360 Italian centers. The eGFR was calculated from data reported in patient notes or hospital database. This post-hoc analysis included 1097 AF patients with eGFR data available and 1-year clinical follow-up. The endpoint was assessed as cardiovascular mortality and/or hospital admission for cardiovascular causes at follow-up. Patients were also divided in two groups according to the eGFR (<60 and ≥60 mL/min/1.73 m2 ). The Kaplan-Meyer curve for the mentioned endpoint showed a higher endpoint incidence in the group of patient with eGFR below 60 mL/min/1.73 m2 (P < 0.001). Using multivariate analysis (Cox regression), a trend toward a higher rate of occurrence of the primary endpoint was observed for eGFR below 60 mL/min/1.73 m2 without reaching the conventional level of statistical significance (hazard ratio [HR] 1.40; 95% confidence interval [CI] 0.99-1.99; P = 0.0572). When eGFR was included in the analysis as continuous variable a significant correlation was observed with the combined endpoint at the Cox regression (HR 0.99, 95% CI 0.98-0.99, P = 0.04). CONCLUSION: The result of this post-hoc analysis indicates that an impaired eGFR is independently associated with worse prognosis among patients with AF.
2018
4-dic-2018
Pubblicato
https://onlinelibrary.wiley.com/doi/full/10.1002/clc.23065
File in questo prodotto:
File Dimensione Formato  
Proietti_et_al-2018-Clinical_Cardiology.pdf

accesso aperto

Tipologia: Documento in Versione Editoriale
Licenza: Copyright Editore
Dimensione 1.06 MB
Formato Adobe PDF
1.06 MB Adobe PDF Visualizza/Apri
clc23065-sup-0001-clc23065.pdf

accesso aperto

Descrizione: Supplementary material
Tipologia: Altro materiale allegato
Licenza: Copyright Editore
Dimensione 174.42 kB
Formato Adobe PDF
174.42 kB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11368/2935656
Citazioni
  • ???jsp.display-item.citation.pmc??? 7
  • Scopus 5
  • ???jsp.display-item.citation.isi??? 5
social impact