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Association of Diff...
Association of Different Estimates of Renal Function With Cardiovascular Mortality and Bleeding in Atrial Fibrillation
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- Hijazi, Ziad (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi
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- Granger, Christopher B. (author)
- Duke Univ, Sch Med, Duke Clin Res Inst, Durham, NC USA.
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- Hohnloser, Stefan H. (author)
- Goethe Univ Frankfurt, Frankfurt, Germany.
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- Westerbergh, Johan (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)
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- Lindbäck, Johan (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Institutionen för medicinska vetenskaper
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- Alexander, John H. (author)
- Duke Univ, Sch Med, Duke Clin Res Inst, Durham, NC USA.
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- Keltai, Matyas (author)
- Semmelweis Univ, Hungarian Inst Cardiol, Budapest, Hungary.
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- Parkhomenko, Alexander (author)
- Inst Cardiol, Kiev, Ukraine.
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- Lopez-Sendon, Jose L. (author)
- Hosp Univ La Paz, IdiPaz, Madrid, Spain.
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- Lopes, Renato D. (author)
- Duke Univ, Sch Med, Duke Clin Res Inst, Durham, NC USA.
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- Siegbahn, Agneta, 1947- (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Klinisk kemi
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- Wallentin, Lars, 1943- (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi
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(creator_code:org_t)
- WILEY, 2020
- 2020
- English.
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In: Journal of the American Heart Association. - : WILEY. - 2047-9980. ; 9:18
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- Background We compared different methods of estimated glomerular filtration rate (eGFR) and their association with cardiovascular death and major bleeding in 14 980 patients with atrial fibrillation in the ARISTOTLE (Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation) trial. Methods and Results eGFR was calculated using equations based on creatinine (Cockcroft-Gault, Modification of Diet in Renal Disease, and Chronic Kidney Disease Epidemiology Collaboration [CKD-EPI]) and/or cystatin C (CKD-EPI(CysC)and CKD-EPICysC+Creatinine). These 5 eGFR equations, as well as the individual variables that are used in these equations, were assessed for correlation and discriminatory ability for cardiovascular death and major bleeding. The median age was 70.0 years, and 35.6% were women. The median eGFR was highest with Cockcroft-Gault (74.1 mL/min) and CKD-EPICysC(74.2 mL/min), and lowest with Modification of Diet in Renal Disease (66.5 mL/min). Correlation between methods ranged from 0.49 (Cockroft-Gault and CKD-EPICysC) to 0.99 (Modification of Diet in Renal Disease and CKD-EPI). Among the eGFR equations, those based on cystatin C yielded the highest C indices for cardiovascular death and major bleeding: 0.628 (CKD-EPICysC) and 0.612 (CKD-EPICysC+Creatinine), respectively. A model based on the variables within the different eGFR equations (age, sex, weight, creatinine, and cystatin C) yielded the highest discriminatory value for both outcomes, with a C index of 0.673 and 0.656, respectively. Conclusions In patients with atrial fibrillation on anticoagulation, correlation between eGFR calculated using different methods varied substantially. Cystatin C-based eGFRs seem to provide the most robust information for predicting death and bleeding. A model based on the individual variables within the eGFR equations, however, provided the highest discriminatory value. Our findings may help refine risk stratification in patients with atrial fibrillation and define how renal function should be determined in future atrial fibrillation studies.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- atrial fibrillation
- bleeding
- outcome
- renal function
Publication and Content Type
- ref (subject category)
- art (subject category)
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Hijazi, Ziad
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Granger, Christo ...
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Hohnloser, Stefa ...
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Westerbergh, Joh ...
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Lindbäck, Johan
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Alexander, John ...
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Keltai, Matyas
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Parkhomenko, Ale ...
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Lopez-Sendon, Jo ...
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Lopes, Renato D.
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Siegbahn, Agneta ...
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Wallentin, Lars, ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
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Journal of the A ...
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Uppsala University