Patients with Atrial Fibrillation and Chronic Kidney Disease More Often Undergo Angioplasty of Left Main Coronary Artery – a 867 Patient Study

Tomaszuk‐Kazberuk, Anna; Nikas, Dimitrios; Łopatowska, Paulina; Młodawska, Elżbieta; Małyszko, Jolanta; Bachórzewska−Gajewska, Hanna; Dobrzycki, Sławomir; Sobkowicz, Bożena; Goudevenos, Ioannis

doi:10.1159/000495637

Cited by 4 publications

(1 citation statement)

References 40 publications

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“…As AF is present in approximately one quarter of the CKD population over the age of 65 [3] and is associated with adverse cardiovascular outcomes [15], identification of simple predictors of hospitalization with AF in CKD patients may optimize risk stratification in this vulnerable population. In the present study, we use data from the Chronic Renal Insufficiency Cohort (CRIC) study to determine the association of QTc, QRS, and PR intervals with AF hospitalizations.…”

Section: Introductionmentioning

confidence: 99%

Specific Electrocardiograph Intervals Predict Hospitalization with Atrial Fibrillation in Those with Chronic Kidney Disease

et al. 2021

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Introduction: Atrial fibrillation (AF) is common in patients with chronic kidney disease (CKD) and is associated with higher rates of hospitalization compared to those without AF. Whether routine electrocardiographic parameters are predictive of future hospitalizations with AF is not clear. Methods: The present study is an analysis of a prospective cohort of 2,759 patients without baseline AF from the Chronic Renal Insufficiency Cohort, a large prospective multicenter study of patients with nondialysis-dependent CKD. Unadjusted and adjusted Cox regression models were fit to examine the association of baseline categories of QTc, QRS, and PR intervals with time to first hospitalization with AF. Restricted cubic splines were used to display nonlinear associations. Results: The mean age of subjects at baseline was 58 ± 11 years, 55% were male, and 44% were Black. The mean follow-up was 6.6 years during which 224 participants experienced a hospitalization with AF. The association of baseline QTc interval with risk of AF hospitalization was nonlinear, such that the lowest and highest quartiles of QTc (<407 and >431 ms, respectively) had higher adjusted risk of AF hospitalization, compared with the second quartile (407–416 ms) (aHR Q1:Q2 1.58, 95% CI 1.03–2.41; p = 0.03; aHR Q4:Q2 1.84, 95% CI 1.22–2.78; p < 0.01). Longer QRS was associated with a higher risk of hospitalization with AF among the subgroup of patients with a history of heart failure (HF). PR interval was not associated with AF hospitalization. Discussion/Conclusion: The association of QTc with risk for hospitalization with AF among patients with CKD is nonlinear, while the association of longer QRS with AF hospitalization is restricted to patients with baseline HF. Electrocardiography may represent a simple and widely accessible method for risk stratification of future AF in patients with CKD.

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Section: Introductionmentioning

confidence: 99%

Specific Electrocardiograph Intervals Predict Hospitalization with Atrial Fibrillation in Those with Chronic Kidney Disease

et al. 2021

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Electrolyte’s imbalance role in atrial fibrillation: Pharmacological management

2022

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The contribution of the perpetuation of atrial fibrillation is caused by electrical remodeling in which calcium, sodium and potassium channels could refer to changes in the ion channel protein expression, development of fibrosis, gene transcription and ion channel redistribution. Calcium and magnesium could influence the risk of atrial fibrillation which is the leading cause of cardiac death, heart failure and ischemic stroke. The elevated serum concentration of calcium had a higher range of in-patient’s mortality, increased total cost of hospitalization and increased length of hospital stay as compared to those without hypercalcemia in atrial fibrillation patients. Moreover, chloride channels could affect homeostasis, atrial myocardial metabolism which may participate in the development of atrial fibrillation. Up to a 50% risk of incidence of AF are higher in which left ventricular hypertrophy, sudden cardiovascular death and overall mortality relate to a low serum magnesium level. Additionally, magnesium prevents the occurrence of AF after cardiac surgery, whereas greater levels of serum phosphorus in the large population-based study and the related calcium–phosphorus products were linked with a greater incidence of AF. Numerous clinical studies had shown the high preoperative risk of AF that is linked with lower serum potassium levels. The conventional risk factor of increased risk of new onset of AF events could independently link with high dietary sodium intake which enhances the fibrosis and inflammation in the atrium but the mechanism remains unknown. Many drugs were used to maintain the electrolyte imbalance in AF patients.

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Antithrombotic therapy in patients with atrial fibrillation undergoing percutaneous coronary intervention, including compliance with current guidelines—data from the POLish Atrial Fibrillation (POL-AF) Registry

Uziębło‐Życzkowska

Krzesiński

Maciorowska

et al. 2021

Cardiovasc Diagn Ther

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Background: Although triple antithrombotic therapy (TAT) is recommended in patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI), guidelines allow an option of dual antithrombotic therapy (DAT). This study assesses the everyday practice of 10 cardiology departments in antithrombotic therapy in AF patients undergoing PCI and its agreement with current guidelines.Methods: This analysis included medical data of AF patients enrolled in the prospective, observational registry (The POLish Atrial Fibrillation-POL-AF) that underwent PCI [elective or due to acute coronary syndrome (ACS)].Results: Of the 3,999 consecutive subjects included, a final analysis was performed on 359 patients that underwent PCI: 148 with urgent PCI due to ACSand 211 patients with elective PCI. Eighty patients in the ACS-group and 120 patients in the elective-PCI group were treated with TAT, although guidelines also allowed DAT. Of 316 patients treated with oral anticoagulants as a part of combination therapy, 275 were on non-vitamin K antagonist oral anticoagulant (NOAC). Reduced doses of NOAC were used in 74 patients treated with rivaroxaban, 60 patients with dabigatran, and 54 patients with apixaban. The proportion of patients treated with reduced NOAC doses adequately to the guidelines was 29%, 100%, and 33% for rivaroxaban, dabigatran, and apixaban, respectively. Inappropriate low doses of NOACs were used in 71% of subjects on rivaroxaban and 67% on apixaban. Conclusions:In patients with AF undergoing PCI, NOACs are definitely preferred over vitamin-K antagonists (VKAs) in TAT/DAT, and an aggressive antithrombotic strategy with TAT is frequently chosen even if DAT is permissible by the guidelines. Label adherence of using reduced NOAC dose during

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Patients with Atrial Fibrillation and Chronic Kidney Disease More Often Undergo Angioplasty of Left Main Coronary Artery – a 867 Patient Study

Cited by 4 publications

References 40 publications

Specific Electrocardiograph Intervals Predict Hospitalization with Atrial Fibrillation in Those with Chronic Kidney Disease

Specific Electrocardiograph Intervals Predict Hospitalization with Atrial Fibrillation in Those with Chronic Kidney Disease

Electrolyte’s imbalance role in atrial fibrillation: Pharmacological management

Antithrombotic therapy in patients with atrial fibrillation undergoing percutaneous coronary intervention, including compliance with current guidelines—data from the POLish Atrial Fibrillation (POL-AF) Registry

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