• 作者：Elsayed Z. Soliman ; Ronald J. Prineas ; Alan S. Go ; Dawei Xie ; James P. Lash ; Mahboob Rahman ; Akinlolu Ojo ; Val L. Teal ; Nancy G. Jensvold ; Nancy L. Robinson ; Daniel L. Dries ; Lydia Bazzano ; Emile R. M
• 刊名：American Heart Journal
• 出版年：2010
• 出版时间：June 2010
• 年：2010
• 卷：159
• 期：6
• 页码：1102-1107
• 全文大小：150 K

Background

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 m²). Atrial fibrillation was present in 18 % of the study population and in >25 % of those ≥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), female 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 m²) 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.