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Background: The epidemiology of atrial fibrillation (AF) has been mainly investigated in patients with end-stage renal disease, with limited data on less advanced chronic kidney disease (CKD) stages.
Methods: A total of 3,267 adult participants (50% non-Hispanic blacks, 46% women) with CKD from the Chronic Renal Insufficiency Cohort 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 electrocardiographic data (n = 22) were excluded. Atrial fibrillation was ascertained by a 12-lead electrocardiogram and self-report. Age-, sex-, and 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.
Results: The mean estimated glomerular filtration rate was 43.6 (+/-13.0) mL/(min 1.73 m(2)). Atrial fibrillation was present in 18% of the study population and in >25% of those > or =70 years old. In multivariable-adjusted models, 1-SD increase in age (11 years) (odds ratio 1.27, CI 95% 1.13-1.43, P < .0001), male [corrected] sex (0.80, 0.65-0.98, P = .0303), smoking (former vs never) (1.34, 1.08-1.66, P = .0081), history of heart failure (3.28, 2.47-4.36, P < .001), and history of cardiovascular disease (1.94, 1.56-2.43, P < .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 glomerular filtration rate <45 mL/(min 1.73 m(2)) was associated with AF in an unadjusted model (1.35, 1.13-1.62, P = .0010), but not after multivariable adjustment (1.12, 0.92-1.35, P = .2710).
Conclusions: Nearly 1 in 5 participants in Chronic Renal Insufficiency Cohort, a national study of CKD, had evidence of AF at study entry, a prevalence similar to that reported among patients with end-stage renal disease and 2 to 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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http://dx.doi.org/10.1016/j.ahj.2010.03.027 | DOI Listing |
Expert Rev Med Devices
December 2024
NorthShore University Health System, Evanston, IL, USA.
Introduction: Proactive esophageal cooling reduces injury during radiofrequency (RF) ablation of the left atrium (LA) for the treatment of atrial fibrillation (AF). New catheters are capable of higher wattage settings up to 90 W (very high-power short duration, vHPSD) for 4s. Varying power and duration however does not eliminate the risk of thermal injury.
View Article and Find Full Text PDFLiver Int
January 2025
Department of Medicine, University of Verona, Verona, Italy.
Background: Studies have reported an association between metabolic dysfunction-associated steatotic liver disease (MASLD) and an increased risk of developing atrial fibrillation (AF). However, the magnitude of the risk and whether this risk varies with the severity of MASLD remains uncertain.
Methods: In this systematic review and meta-analysis, we searched three large electronic databases using predefined keywords to identify cohort studies (published up to 30 September 2024) in which MASLD was diagnosed by liver biopsy, imaging methods, International Classification of Diseases (ICD) codes, or blood-based scores.
Exp Ther Med
February 2025
Department of Urology, Konstantopouleio-Patision General Hospital of Nea Ionia, 14233 Nea Ionia, Greece.
A 79-year old Caucasian male with metastatic hormone refractory prostate cancer and bilateral nephrostomy was admitted to the emergency department due to 4-day bloody urethral discharge, weakness and dizziness. The patient was treated with the luteinizing hormone-releasing hormone-antagonist and abiraterone acetate plus prednisone, dabigatran 150 mg bid (for atrial fibrillation and coronary heart disease) and 5-aminosalicylic acid for the management of mild ulcerative colitis. Imaging revealed bladder overdistention and blood analysis low levels of hematocrit (HCT) and hemoglobin (HGB) (HCT, 22%; HGB, 7.
View Article and Find Full Text PDFJ Blood Med
December 2024
Department of Pharmacy, Kathmandu University, Dhulikhel, Nepal.
Purpose: Atrial fibrillation (AF) being a prevalent cardiovascular condition globally, has an increased risk of stroke and other complications. The effective management of AF often involves the use of oral anticoagulants (OACs) to prevent thromboembolic events. This study aimed to evaluate anticoagulation knowledge and medication adherence in AF patients on OACs at a tertiary care center in Nepal.
View Article and Find Full Text PDFEClinicalMedicine
January 2025
Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China.
Background: The absolute overall survival (OS) improvement with preoperative chemotherapy or chemoradiotherapy in locally advanced non-small cell lung cancer (NSCLC) patients is controversial and unsatisfactory. We designed this trial to explore the efficacy and safety of perioperative sintilimab plus platinum-based chemotherapy for potentially resectable stage IIIB NSCLC to facilitate further optimization of this therapeutic strategy.
Methods: Patients diagnosed with stage IIIB NSCLC through invasive staging approaches and/or PET/CT scans and evaluated as having a high probability of radical resection of the primary lesion and metastatic lymph nodes with clear pathological margins by a multidisciplinary team were enrolled in this open-label, single-arm, phase II trial at a single centre in China.
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