Impact of estimated glomerular filtration rate on long-term clinical outcomes among Chinese patients with atrial fibrillation

Huaibin Wan,Juan Wang,Ning Bian,Xin Fan,Dongdong Chen,Yanmin Yang

doi:10.1186/s12872-020-01786-6

Abstract

BackgroundEstimated glomerular filtration rate (eGFR) is a widely accepted indicator of renal function. The aim of this study was to evaluate the relationship between eGFR and 3-year clinical outcomes among Chinese patients with atrial fibrillation (AF).MethodsWe retrospectively studied 433 consecutive Chinese patients with AF (51.0% males, mean age 65.6 ± 13.2 years) between February 2013 and December 2017. Baseline clinical data were collected according to medical records. eGFR was calculated by MDRD equation for Chinese patients according to baseline age, sex and serum creatinine. The primary clinical outcome of interest was all-cause mortality.ResultsDuring a median follow-up period of 3.1 (0.5–4.5) years, 73 deaths (16.9%) were recorded. Multivariate Cox regression analyses indicated that eGFR was independently associated with all-cause death in total population [hazard ratio (HR) 0.984; 95% confidence interval (CI) 0.972–0.995, P = 0.006] and patients free of valvular heart diseases (VHDs) (HR 0.975; 95% CI 0.959–0.992, P = 0.003), but not with VHDs. A receiver operating characteristic (ROC) analysis revealed that reduced eGFR predicted all-cause mortality with areas under the ROC curve of 0.637 (95% CI 0.539–0.735, P = 0.004) in AF patients free of VHDs.ConclusionseGFR is an independent predictor of 3-year all-cause mortality among Chinese patients with AF, especially among those patients free of VHDs.

Highlights

Estimated glomerular filtration rate is a widely accepted indicator of renal function
Mean Estimated glomerular filtration rate (eGFR) of the total population was 70.1 ± 26.9 ml/min per 1.73 m2, about 35.6% of them exhibited a renal impairment, and no significant difference was observed in renal function among the groups
We demonstrated that reduced eGFR was a poor prognostic factor of longterm clinical outcomes among Chinese patients with atrial fibrillation (AF), especially among those free of Valvular heart disease (VHD)

Summary

Introduction

Estimated glomerular filtration rate (eGFR) is a widely accepted indicator of renal function. The aim of this study was to evaluate the relationship between eGFR and 3-year clinical outcomes among Chinese patients with atrial fibrillation (AF). Glomerular filtration rate (GFR), which can be estimated from age, sex and serum creatinine (estimated GFR, eGFR), is a widely accepted indicator of AF and chronic kidney disease (CKD) frequently coexist [11]. Programme AF General Pilot Registry (EORP-AF), even mild or moderate renal impairments were associated with an increased risks of cardiovascular events and death [12]. No investigation regarding the relationship between renal impairment and long-term clinical outcomes has been conducted in general Chinese patients with AF. In this study, we evaluated the impact of eGFR on long-term mortality in Chinese patients with AF

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