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Chronic kidney disease is associated with the incidence of atrial fibrillation: the Atherosclerosis Risk in Communities (ARIC) study.
Circulation 2011; 123(25):2946-53Circ

Abstract

BACKGROUND

Chronic kidney disease is associated with the incidence of cardiovascular disease. Chronic kidney disease may also increase the risk of atrial fibrillation (AF), but existing studies have reported inconsistent results.

METHODS AND RESULTS

We estimated cystatin C-based glomerular filtration rate (eGFR(cys)) and measured urinary albumin-to-creatinine ratio (ACR) in 10 328 men and women free of AF from the Atherosclerosis Risk in Communities (ARIC) Study in 1996 to 1998. Incidence of AF was ascertained through the end of 2007. During a median follow-up of 10.1 years, we identified 788 incident AF cases. Compared with individuals with eGFR(cys) ≥90 mL · min(-1) · 1.73 m(-2), multivariable hazard ratios and 95% confidence intervals (CIs) of AF were 1.3 (95% CI, 1.1 to 1.6), 1.6 (95% CI, 1.3 to 2.1), and 3.2 (95% CI, 2.0 to 5.0; P for trend <0.0001) in those with eGFR(cys) of 60 to 89, 30 to 59, and 15 to 29 mL · min(-1) · 1.73 m(-2), respectively. Similarly, the presence of macroalbuminuria (ACR ≥300 mg/g; hazard ratio, 3.2; 95% CI, 2.3 to 4.5) and microalbuminuria (ACR, 30 to 299 mg/g; hazard ratio, 2.0; 95% CI, 1.6 to 2.4) was associated with higher AF risk compared with those with ACR <30 mg/g. Risk of AF was particularly elevated in those with both low eGFR(cys) and macroalbuminuria (hazard ratio, 13.1; 95% CI, 6.0 to 28.6, comparing individuals with ACR ≥300 mg/g and eGFR(cys) of 15 to 29 mL · min(-1) · 1.73 m(-2) and those with ACR <30 mg/g and eGFR(cys) ≥90 mL · min(-1) · 1.73 m(-2)).

CONCLUSION

In this large population-based study, reduced kidney function and presence of albuminuria were strongly associated with the incidence of AF independently of other risk factors.

Authors+Show Affiliations

Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S 2nd Street, Minneapolis, MN 55454, USA. alonso@umn.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21646496

Citation

Alonso, Alvaro, et al. "Chronic Kidney Disease Is Associated With the Incidence of Atrial Fibrillation: the Atherosclerosis Risk in Communities (ARIC) Study." Circulation, vol. 123, no. 25, 2011, pp. 2946-53.
Alonso A, Lopez FL, Matsushita K, et al. Chronic kidney disease is associated with the incidence of atrial fibrillation: the Atherosclerosis Risk in Communities (ARIC) study. Circulation. 2011;123(25):2946-53.
Alonso, A., Lopez, F. L., Matsushita, K., Loehr, L. R., Agarwal, S. K., Chen, L. Y., ... Coresh, J. (2011). Chronic kidney disease is associated with the incidence of atrial fibrillation: the Atherosclerosis Risk in Communities (ARIC) study. Circulation, 123(25), pp. 2946-53. doi:10.1161/CIRCULATIONAHA.111.020982.
Alonso A, et al. Chronic Kidney Disease Is Associated With the Incidence of Atrial Fibrillation: the Atherosclerosis Risk in Communities (ARIC) Study. Circulation. 2011 Jun 28;123(25):2946-53. PubMed PMID: 21646496.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chronic kidney disease is associated with the incidence of atrial fibrillation: the Atherosclerosis Risk in Communities (ARIC) study. AU - Alonso,Alvaro, AU - Lopez,Faye L, AU - Matsushita,Kunihiro, AU - Loehr,Laura R, AU - Agarwal,Sunil K, AU - Chen,Lin Y, AU - Soliman,Elsayed Z, AU - Astor,Brad C, AU - Coresh,Josef, Y1 - 2011/06/06/ PY - 2011/6/8/entrez PY - 2011/6/8/pubmed PY - 2011/9/2/medline SP - 2946 EP - 53 JF - Circulation JO - Circulation VL - 123 IS - 25 N2 - BACKGROUND: Chronic kidney disease is associated with the incidence of cardiovascular disease. Chronic kidney disease may also increase the risk of atrial fibrillation (AF), but existing studies have reported inconsistent results. METHODS AND RESULTS: We estimated cystatin C-based glomerular filtration rate (eGFR(cys)) and measured urinary albumin-to-creatinine ratio (ACR) in 10 328 men and women free of AF from the Atherosclerosis Risk in Communities (ARIC) Study in 1996 to 1998. Incidence of AF was ascertained through the end of 2007. During a median follow-up of 10.1 years, we identified 788 incident AF cases. Compared with individuals with eGFR(cys) ≥90 mL · min(-1) · 1.73 m(-2), multivariable hazard ratios and 95% confidence intervals (CIs) of AF were 1.3 (95% CI, 1.1 to 1.6), 1.6 (95% CI, 1.3 to 2.1), and 3.2 (95% CI, 2.0 to 5.0; P for trend <0.0001) in those with eGFR(cys) of 60 to 89, 30 to 59, and 15 to 29 mL · min(-1) · 1.73 m(-2), respectively. Similarly, the presence of macroalbuminuria (ACR ≥300 mg/g; hazard ratio, 3.2; 95% CI, 2.3 to 4.5) and microalbuminuria (ACR, 30 to 299 mg/g; hazard ratio, 2.0; 95% CI, 1.6 to 2.4) was associated with higher AF risk compared with those with ACR <30 mg/g. Risk of AF was particularly elevated in those with both low eGFR(cys) and macroalbuminuria (hazard ratio, 13.1; 95% CI, 6.0 to 28.6, comparing individuals with ACR ≥300 mg/g and eGFR(cys) of 15 to 29 mL · min(-1) · 1.73 m(-2) and those with ACR <30 mg/g and eGFR(cys) ≥90 mL · min(-1) · 1.73 m(-2)). CONCLUSION: In this large population-based study, reduced kidney function and presence of albuminuria were strongly associated with the incidence of AF independently of other risk factors. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/21646496/Chronic_kidney_disease_is_associated_with_the_incidence_of_atrial_fibrillation:_the_Atherosclerosis_Risk_in_Communities__ARIC__study_ L2 - http://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.111.020982?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -