Association of Estimated Glomerular Filtration Rate Trajectories with Atrial Fibrillation Risk in Populations with Normal or Mildly Impaired Renal Function

IF 4.3 3区 材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC
Chi Wang, Qian Xin, Junjuan Li, Jianli Wang, S. Yao, Miao Wang, Maoxiang Zhao, Shuohua Chen, Shouling Wu, Hao Xue
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引用次数: 0

Abstract

Introduction: The association between the longitudinal patterns of estimated glomerular filtration rate (eGFR) and risk of atrial fibrillation (AF) in populations with normal or mildly impaired renal function is not well-characterized. We sought to explore the eGFR trajectories in populations with normal or mildly impaired renal function and their association with AF. Methods: This prospective cohort study included 62,407 participants who were free of AF, cardiovascular diseases, and moderate to severe renal insufficiency (eGFR <60 mL/min/1.73m2) before 2010. The eGFR trajectories were developed using latent mixture modeling based on examination data in 2006, 2008, and 2010. Incident AF cases were identified in biennial electrocardiogram assessment and a review of medical insurance data and discharge registers. We used Cox regression models to estimate the hazard ratios and 95% confidence intervals (CI) for incident AF. Results: According to survey results for the range and changing pattern of eGFR during 2006 to 2010, four trajectories were identified: high-stable (range, 107.47 to 110.25 mL/min/1.73m2; n=11,719), moderate-increasing (median increase from 83.83 to 100.37 mL/min/1.73m2; n=22,634), high-decreasing (median decrease from 101.72 to 89.10 mL/min/1.73m2; n=7,943), and low-stable (range, 73.48 to 76.78 mL/min/1.73m2; n=20,111). After an average follow-up of 9.63 years, a total of 485 cases of AF were identified. Compared with the high-stable trajectory, the adjusted hazard ratios of AF were 1.70 (95% CI, 1.09–2.66) for the moderate-increasing trajectory, 1.92 (95% CI, 1.18–3.13) for the high-decreasing trajectory, and 2.28 (95% CI, 1.46–3.56) for the low-stable trajectory. The results remained consistent across a number of sensitivity analyses. Conclusions: The trajectories of eGFR were associated with subsequent AF risk in populations with normal or mildly impaired renal function.
肾功能正常或轻度受损人群的估计肾小球滤过率轨迹与心房颤动风险的关系
导言:在肾功能正常或轻度受损的人群中,估计肾小球滤过率(eGFR)的纵向模式与心房颤动(AF)风险之间的关系尚未得到很好的描述。我们试图探索肾功能正常或轻度受损人群的 eGFR 轨迹及其与房颤的关系。方法:这项前瞻性队列研究共纳入了 62407 名参与者,他们在 2010 年之前没有房颤、心血管疾病和中重度肾功能不全(eGFR <60 mL/min/1.73m2)。eGFR轨迹是根据2006年、2008年和2010年的检查数据,采用潜在混合模型得出的。通过两年一次的心电图评估以及对医疗保险数据和出院登记册的审查,确定了心房颤动的发病病例。我们使用 Cox 回归模型估算了心房颤动发病的危险比和 95% 的置信区间 (CI)。结果:根据 2006 年至 2010 年期间 eGFR 范围和变化模式的调查结果,确定了四种轨迹:高度稳定(范围为 107.47 至 110.25 mL/min/1.73m2;n=11,719)、中度增加(中位数从 83.83到100.37 mL/min/1.73m2; n=22,634)、高度下降(中位数从101.72下降到89.10 mL/min/1.73m2; n=7,943)和低度稳定(范围从73.48到76.78 mL/min/1.73m2; n=20,111)。经过平均 9.63 年的随访,共发现 485 例房颤病例。与高稳定轨迹相比,中度增加轨迹的房颤调整危险比为 1.70(95% CI,1.09-2.66),高度减少轨迹的房颤调整危险比为 1.92(95% CI,1.18-3.13),低稳定轨迹的房颤调整危险比为 2.28(95% CI,1.46-3.56)。这些结果在多项敏感性分析中保持一致:在肾功能正常或轻度受损的人群中,eGFR的变化轨迹与后续房颤风险相关。
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来源期刊
CiteScore
7.20
自引率
4.30%
发文量
567
期刊介绍: ACS Applied Electronic Materials is an interdisciplinary journal publishing original research covering all aspects of electronic materials. The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrate knowledge in the areas of materials science, engineering, optics, physics, and chemistry into important applications of electronic materials. Sample research topics that span the journal's scope are inorganic, organic, ionic and polymeric materials with properties that include conducting, semiconducting, superconducting, insulating, dielectric, magnetic, optoelectronic, piezoelectric, ferroelectric and thermoelectric. Indexed/​Abstracted: Web of Science SCIE Scopus CAS INSPEC Portico
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