Incremental prognostic value of renal function for stroke prediction in atrial fibrillation

International Journal of Cardiology
Emily C O'BrienORBIT-AF Patients & Investigators

Abstract

Renal function has been associated with an increased stroke risk in patients with atrial fibrillation (AF). However, whether renal function incrementally adds to risk prediction in both anticoagulated and non-anticoagulated patients with AF is unclear. We used data from the Outcomes Registry for Better Informed Treatment of AF (ORBIT-AF)-a national, prospective, outpatient AF registry in patients aged >18 years (2010-2011). The association between baseline renal function and risk of stroke/systemic embolism (SSE) was evaluated in proportional hazards models adjusting for stroke risk score components. We compared discrimination of 2-year outcomes using C-indices and evaluated calibration by comparing event rates in ORBIT-AF to published rates from an external clinical trial population (ROCKET AF) and an observational cohort (ATRIA). Among 9743 patients included in the analysis, the median age was 75 years (interquartile range [IQR] 67-82), 89.5% were white, 43% were female, and 76% were taking oral anticoagulation (OAC). Over a median follow-up of 2.3 years, 214 SSE events occurred (1.00 per 100 patient-years). Continuous creatinine clearance (CrCl) was not associated with SSE risk after adjusting for other clinical factors (com...Continue Reading

Citations

May 2, 2019·Heart·Agnieszka Kapłon-CieślickaGrzegorz Opolski
Aug 6, 2020·Journal of Clinical Medicine·Paweł T MatusikAnetta Undas
Aug 2, 2021·European Heart Journal·Giulio Francesco RomitiUNKNOWN AF-COMET International Collaborative Group

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