慢性肾病与三度房室传导阻滞之间的关系：一项丹麦全国性研究。

IF 8 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Clinical electrophysiology Pub Date : 2025-02-01 DOI:10.1016/j.jacep.2024.10.007

Hannah K. Wood-Kurland MD , Anne Storgaard Nørskov MD , Nicholas Carlson MD, PhD , Anders Møller Greve MD, PhD , Lars Køber MD, DMSc , Gunnar Gislason MD, PhD , Christian Torp-Pedersen MD, DMSc , Casper N. Bang MD, PhD

{"title":"慢性肾病与三度房室传导阻滞之间的关系：一项丹麦全国性研究。","authors":"Hannah K. Wood-Kurland MD , Anne Storgaard Nørskov MD , Nicholas Carlson MD, PhD , Anders Møller Greve MD, PhD , Lars Køber MD, DMSc , Gunnar Gislason MD, PhD , Christian Torp-Pedersen MD, DMSc , Casper N. Bang MD, PhD","doi":"10.1016/j.jacep.2024.10.007","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Chronic kidney disease (CKD) is frequently complicated by arrhythmias, plausibly leading to the increased risk of sudden cardiac death in this population. However, little is known about the association between CKD and third-degree atrioventricular block (3AVB) and need for permanent pacing.</div></div><div><h3>Objectives</h3><div>This study aimed to investigate the association between CKD and 3AVB.</div></div><div><h3>Methods</h3><div>In a population-based nested case-control study, patients with 3AVB were identified between July 1995 and December 2018 using Danish administrative registries. Cases were risk set matched 1:5 with controls on sex and birth year. Multivariable Cox regression was used to analyze the association between CKD and 3AVB, with subsequent logistic regression analyses for computation of odds ratios for pacemaker implantation stratified by dialysis or nondialysis CKD.</div></div><div><h3>Results</h3><div>A total of 31,301 patients with 3AVB were identified and matched with 155,506 controls. The mean age was 74.7 ± 12 years, and 40.2% were female. A significant association was found between CKD and 3AVB after adjustment for comorbidities and potential atrioventricular node blocking agents (HR: 1.83; 95% CI: 1.73-1.93). In stratified analyses, the association was stronger in patients using dialysis compared with nondialysis patients (HR: 7.71; 95% CI: 5.84-10.18; vs HR: 1.73; 95% CI: 1.64-1.83). The odds of pacemaker implantation were lower for patients using dialysis (OR: 0.77; 95% CI: 0.60-0.98) but comparable between patients with nondialysis CKD (OR: 1.04; 95% CI: 0.96-1.12) and patients without CKD.</div></div><div><h3>Conclusions</h3><div>CKD was independently associated with a higher rate of 3AVB, especially for patients using dialysis.</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 2","pages":"Pages 376-385"},"PeriodicalIF":8.0000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Association Between Chronic Kidney Disease and Third-Degree Atrioventricular Block\",\"authors\":\"Hannah K. Wood-Kurland MD , Anne Storgaard Nørskov MD , Nicholas Carlson MD, PhD , Anders Møller Greve MD, PhD , Lars Køber MD, DMSc , Gunnar Gislason MD, PhD , Christian Torp-Pedersen MD, DMSc , Casper N. Bang MD, PhD\",\"doi\":\"10.1016/j.jacep.2024.10.007\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Chronic kidney disease (CKD) is frequently complicated by arrhythmias, plausibly leading to the increased risk of sudden cardiac death in this population. However, little is known about the association between CKD and third-degree atrioventricular block (3AVB) and need for permanent pacing.</div></div><div><h3>Objectives</h3><div>This study aimed to investigate the association between CKD and 3AVB.</div></div><div><h3>Methods</h3><div>In a population-based nested case-control study, patients with 3AVB were identified between July 1995 and December 2018 using Danish administrative registries. Cases were risk set matched 1:5 with controls on sex and birth year. Multivariable Cox regression was used to analyze the association between CKD and 3AVB, with subsequent logistic regression analyses for computation of odds ratios for pacemaker implantation stratified by dialysis or nondialysis CKD.</div></div><div><h3>Results</h3><div>A total of 31,301 patients with 3AVB were identified and matched with 155,506 controls. The mean age was 74.7 ± 12 years, and 40.2% were female. A significant association was found between CKD and 3AVB after adjustment for comorbidities and potential atrioventricular node blocking agents (HR: 1.83; 95% CI: 1.73-1.93). In stratified analyses, the association was stronger in patients using dialysis compared with nondialysis patients (HR: 7.71; 95% CI: 5.84-10.18; vs HR: 1.73; 95% CI: 1.64-1.83). The odds of pacemaker implantation were lower for patients using dialysis (OR: 0.77; 95% CI: 0.60-0.98) but comparable between patients with nondialysis CKD (OR: 1.04; 95% CI: 0.96-1.12) and patients without CKD.</div></div><div><h3>Conclusions</h3><div>CKD was independently associated with a higher rate of 3AVB, especially for patients using dialysis.</div></div>\",\"PeriodicalId\":14573,\"journal\":{\"name\":\"JACC. Clinical electrophysiology\",\"volume\":\"11 2\",\"pages\":\"Pages 376-385\"},\"PeriodicalIF\":8.0000,\"publicationDate\":\"2025-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JACC. Clinical electrophysiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2405500X24008715\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JACC. Clinical electrophysiology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2405500X24008715","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

摘要

背景：慢性肾脏疾病（CKD）经常并发心律失常，可能导致该人群心源性猝死的风险增加。然而，CKD与三度房室传导阻滞（3AVB）和需要永久性起搏之间的关系知之甚少。目的：本研究旨在探讨CKD与3AVB之间的关系。方法：在一项基于人群的巢式病例对照研究中，使用丹麦行政登记处在1995年7月至2018年12月期间确定了3AVB患者。病例的风险设置为1:5，性别和出生年份为对照。采用多变量Cox回归分析CKD与3AVB之间的关系，随后进行logistic回归分析，计算透析或非透析CKD分层起搏器植入的优势比。结果：共发现31,301例3AVB患者，并与155,506例对照进行匹配。平均年龄74.7±12岁，女性占40.2%。在调整合并症和潜在房室结阻滞剂后，CKD和3AVB之间存在显著关联(HR: 1.83；95% ci: 1.73-1.93)。在分层分析中，与非透析患者相比，透析患者的相关性更强(HR: 7.71；95% ci: 5.84-10.18；vs HR: 1.73；95% ci: 1.64-1.83)。透析患者植入起搏器的几率较低(OR: 0.77；95% CI: 0.60-0.98)，但非透析性CKD患者之间具有可比性(OR: 1.04；95% CI: 0.96-1.12)和无CKD患者。结论：CKD与较高的3AVB率独立相关，尤其是透析患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

The Association Between Chronic Kidney Disease and Third-Degree Atrioventricular Block

Background

Chronic kidney disease (CKD) is frequently complicated by arrhythmias, plausibly leading to the increased risk of sudden cardiac death in this population. However, little is known about the association between CKD and third-degree atrioventricular block (3AVB) and need for permanent pacing.

Objectives

This study aimed to investigate the association between CKD and 3AVB.

Methods

In a population-based nested case-control study, patients with 3AVB were identified between July 1995 and December 2018 using Danish administrative registries. Cases were risk set matched 1:5 with controls on sex and birth year. Multivariable Cox regression was used to analyze the association between CKD and 3AVB, with subsequent logistic regression analyses for computation of odds ratios for pacemaker implantation stratified by dialysis or nondialysis CKD.

Results

A total of 31,301 patients with 3AVB were identified and matched with 155,506 controls. The mean age was 74.7 ± 12 years, and 40.2% were female. A significant association was found between CKD and 3AVB after adjustment for comorbidities and potential atrioventricular node blocking agents (HR: 1.83; 95% CI: 1.73-1.93). In stratified analyses, the association was stronger in patients using dialysis compared with nondialysis patients (HR: 7.71; 95% CI: 5.84-10.18; vs HR: 1.73; 95% CI: 1.64-1.83). The odds of pacemaker implantation were lower for patients using dialysis (OR: 0.77; 95% CI: 0.60-0.98) but comparable between patients with nondialysis CKD (OR: 1.04; 95% CI: 0.96-1.12) and patients without CKD.

Conclusions

CKD was independently associated with a higher rate of 3AVB, especially for patients using dialysis.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

JACC. Clinical electrophysiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

10.30

自引率

5.70%

发文量

250

期刊介绍： JACC: Clinical Electrophysiology is one of a family of specialist journals launched by the renowned Journal of the American College of Cardiology (JACC). It encompasses all aspects of the epidemiology, pathogenesis, diagnosis and treatment of cardiac arrhythmias. Submissions of original research and state-of-the-art reviews from cardiology, cardiovascular surgery, neurology, outcomes research, and related fields are encouraged. Experimental and preclinical work that directly relates to diagnostic or therapeutic interventions are also encouraged. In general, case reports will not be considered for publication.