Chronic kidney disease and prevalent atrial fibrillation: the Chronic Renal Insufficiency Cohort (CRIC).
Chronic kidney disease and prevalent atrial fibrillation: the Chronic Renal Insufficiency Cohort (CRIC).
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DOI：
10.1016/j.ahj.2010.03.027
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发表时间：
2010-06
影响因子：
4.8
通讯作者：
Chronic Renal Insufficiency Cohort (CRIC) Study Group
中科院分区：
文献类型：
--
作者：
Soliman EZ;Prineas RJ;Go AS;Xie D;Lash JP;Rahman M;Ojo A;Teal VL;Jensvold NG;Robinson NL;Dries DL;Bazzano L;Mohler ER;Wright JT;Feldman HI;Chronic Renal Insufficiency Cohort (CRIC) Study Group
心房颤动(AF)的流行病学研究主要集中在终末期肾病(ESRD)患者中，对慢性肾脏病(CKD)进展较慢的患者的研究数据有限。来自慢性肾功能不全队列(CRIC)的3267名成年参与者(50%非西班牙裔黑人，46%女性)患有慢性肾功能不全(CRIC)。研究参与者中没有一人接受过透析。排除那些自我认同的种族/民族，非西班牙裔黑人或白人(N=323)或没有心电数据的人(N=22)。房颤由12导联心电图和自我报告确定。对年龄、性别、种族/民族的房颤患病率进行评估，并在亚组间进行比较。使用未经调整和多变量调整的Logistic回归分析来检验横断面与房颤流行的关联性和相关性。平均估计肾小球滤过率(GFR)为43.6(±13.0)ml/min/1.73m2。房颤在18%的研究人群中存在，在70岁或以上的人群中超过25%。在多变量调整模型中，年龄(11岁)[优势比(OR)和可信区间95%：1.27(1.13，1.43)，P<；0.0001]、女性[0.80(0.65，0.98)，P=0.0303]、吸烟(既往与从未)[1.34(1.08，1.66)，P=0.0081]、心力衰竭病史[3.28(2.47，4.36)，P<；0.001，心血管病史[1.94(1.56，2.43)，P<；0.0001]与房颤显著相关。种族/民族、高血压、糖尿病、体重指数、体力活动、教育程度、超敏C反应蛋白、总胆固醇和饮酒与房颤无显著关联。在未调整的模型中，估计的45ml/min/1.73m2与房颤相关[1.35(1.13-1.62)；P=0.0010]，但在多变量调整后[1.12(0.92-1.35)，P=0.2710]。CRIC是一项针对CKD的全国性研究，近五分之一的参与者在研究开始时就有房颤的证据，这一发病率与ESRD患者中报告的患病率相似，是普通人群中报告的2-3倍。在这个CKD人群中，房颤的危险因素并不反映在普通人群中报道的那些。
The epidemiology of atrial fibrillation (AF) has been mainly investigated in patients with end-stage renal disease (ESRD), with limited data on less advanced chronic kidney disease (CKD) stages. A total of 3267 adult participants (50% non-Hispanic blacks, 46% females) with CKD from the Chronic Renal Insufficiency Cohort (CRIC) were included in this study. None of the study participants had been on dialysis. Those with self-identified race/ethnicity other than non-Hispanic black or white (N=323) or those without ECG data (N=22) were excluded. AF was ascertained by a 12-lead electrocardiogram (ECG) and self-report. Age- sex- race/ethnicity-specific prevalence rates of AF were estimated and compared between subgroups. Cross sectional associations and correlates with prevalent AF were examined using unadjusted and multivariable adjusted logistic regression analysis. The mean estimated glomerular filtration rate (GFR) was 43.6 (±13.0) ml/min/1.73 m2. AF was present in 18% of the study population and in more than 25% of those 70 years or older. In multivariable adjusted models, 1-SD increase in age (11 years) [odds ratio (OR) and CI 95%: 1.27 (1.13, 1.43), P<0.0001], female sex [0.80 (0.65, 0.98), P=0.0303], smoking (former vs. never) [1.34 (1.08, 1.66), P= 0.0081], history of heart failure [3.28 (2.47, 4.36), P<0.001], and history of cardiovascular disease [1.94 (1.56, 2.43), P<0.0001] were significantly associated with AF. Race/ethnicity, hypertension, diabetes, body mass index, physical activity, education, high sensitivity C-reactive protein, total cholesterol, and alcohol intake were not significantly associated with AF. An estimated GFR <45 ml/min/1.73 m2 was associated with AF in an unadjusted model [1.35 (1.13–1.62)); P=0.0010)], but not after multivariable adjustment [1.12 (0.92– 1.35), P=0.2710]. Nearly one in five participants in CRIC, a national study of CKD, had evidence for AF at study entry, a prevalence similar to that reported among patients with ESRD and 2–3 times of that reported in the general population. Risk factors for AF in this CKD population do not mirror those reported in the general population.
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影响因子：
2.8
作者：
Iguchi, Yasuyuki;Kimura, Kazumi;Shibazaki, Kensaku
通讯作者：
Shibazaki, Kensaku
影响因子：
13.2
作者：
Bologa, RM;Levine, DM;Rubin, AL
通讯作者：
Rubin, AL
影响因子：
2.8
作者：
FURBERG, CD;PSATY, BM;RAUTAHARJU, PM
通讯作者：
RAUTAHARJU, PM
影响因子：
37.8
作者：
Chung, MK;Martin, DO;Van Wagoner, DR
通讯作者：
Van Wagoner, DR
影响因子：
37.8
作者：
Aviles, RJ;Martin, DO;Chung, MK
通讯作者：
Chung, MK