Characterization of baseline clinical factors associated with incident worsening kidney function in patients with non-valvular atrial fibrillation: the Hokuriku-Plus AF Registry
Characterization of baseline clinical factors associated with incident worsening kidney function in patients with non-valvular atrial fibrillation: the Hokuriku-Plus AF Registry
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与非瓣膜性房颤患者肾功能恶化相关的基线临床因素的特征：Hokuriku-Plus AF 登记
DOI：
10.1007/s00380-022-02178-w
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发表时间：
2022
影响因子：
1.5
通讯作者：
et al.
中科院分区：
文献类型：
--
作者：
Hayashi Kenshi;et al.
有证据表明，房颤（AF）可能会增加肾功能恶化（WKF）的风险，这与AF患者的卒中、出血和死亡风险增加有关。然而，关于这些患者中可能导致WKF的因素的数据有限。因此，我们试图确定与非瓣膜性房颤（NVAF）患者发生WKF相关的潜在因素。我们前瞻性分析了1122例NVAF患者[男性71.9%，中位年龄73.0岁（四分位距：66.0-79.0）]，基线估计肾小球滤过率（eGFR）≥ 15 mL/min/1.73 m2，来自Hokuriku-Plus AF登记研究。主要结局为WKF事件，定义为随访期间eGFR较基线的变化% ≥ 30%。我们使用单变量和多变量考克斯比例风险模型评估基线变量和WKF事件之间的关联。我们还评估了确定的因素和事件WKF之间的非线性关联。中位随访期为3.0年（四分位距：2.7-3.3），在108例患者中观察到WKF事件（32.6/1000人-年）。与未发生WKF的患者相比，发生WKF的患者年龄更大，基线时心力衰竭（HF）、糖尿病（DM）和血管疾病的患病率更高。发生WKF事件的患者舒张压升高，血红蛋白降低，eGFR降低，B型利钠肽（BNP）升高，华法林使用频率增加。多变量分析显示，年龄≥ 75岁、HF、DM和贫血与WKF事件独立相关。此外，年龄和血红蛋白与WKF事件的风险呈线性相关，而HbA 1c和BNP则呈J形或U形相关。年龄≥ 75岁、HF、DM和贫血与日本NVAF患者发生WKF相关。在有这些风险因素的患者中，仔细监测肾功能和适当的干预措施可能很重要。
Evidence suggests that atrial fibrillation (AF) could increase the risk of worsening kidney function (WKF) which is linked to an increased risk of stroke, bleeding, and death in AF patients. However, limited data exist regarding the factors that could lead to WKF in these patients. Therefore, we sought to identify the potential factors associated with the development of WKF in patients with non-valvular AF (NVAF). We analyzed prospectively recruited 1122 NVAF patients [men 71.9%, median age 73.0 years (interquartile range: 66.0–79.0)] with a baseline estimated glomerular filtration rate (eGFR) ≥ 15 mL/min/1.73 m2from the Hokuriku-Plus AF Registry. The primary outcome was incident WKF, defined as the %eGFR change from the baseline ≥ 30% during the follow-up period. We evaluated the association between baseline variables and incident WKF using univariate and multivariate Cox proportional hazard models. We also evaluated the non-linear association between the identified factors and incident WKF. During a median follow-up period of 3.0 years (interquartile range: 2.7–3.3), incident WKF was observed in 108 patients (32.6 per 1000 person-years). Compared to the patients without incident WKF, the patients with incident WKF were older and had a higher prevalence of heart failure (HF), diabetes mellitus (DM), and vascular disease at baseline. Those who experienced incident WKF also had higher diastolic blood pressure, lower hemoglobin, lower eGFR, higher B-type natriuretic peptide (BNP) and used warfarin more frequently. Upon multivariate analysis, age ≥ 75 years, HF, DM, and anemia were independently associated with incident WKF. Additionally, age and hemoglobin were linearly associated with the risk of incident WKF, whereas a J- or U-shaped association was observed for HbA1c and BNP. Age ≥ 75 years, HF, DM, and anemia were associated with the development of WKF in Japanese patients with NVAF. In patients with these risk factors, a careful monitoring of the kidney function and appropriate interventions may be important when possible.
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影响因子：
5.4
作者：
Molnar AO;Eddeen AB;Ducharme R;Garg AX;Harel Z;McCallum MK;Perl J;Wald R;Zimmerman D;Sood MM
通讯作者：
Sood MM
影响因子：
8.3
作者：
WOLF, PA;ABBOTT, RD;KANNEL, WB
通讯作者：
KANNEL, WB
影响因子：
2.5
作者：
Mitsuma, Wataru;Matsubara, Taku;Miyazaki, Shigeru
通讯作者：
Miyazaki, Shigeru
患有房颤的透析患者的临床特征和结果：伏见 AF 登记处
影响因子：
1.5
作者：
Y. Yamashita;D. Takagi;Y. Hamatani;M. Iguchi;N. Masunaga;M. Esato;Y. Chun;Hitoshi Itoh;M. Nishimura;H. Wada;K. Hasegawa;H. Ogawa;M. Abe;M. Akao
通讯作者：
M. Akao
影响因子：
2.3
作者：
Kanda E;Usui T;Kashihara N;Iseki C;Iseki K;Nangaku M
通讯作者：
Nangaku M