Association of Proteinuria and Incident Atrial Fibrillation in Patients With Intact and Reduced Kidney Function

• DOI: 10.1161/jaha.117.005685
• Publication Date: 2017-07-07T00:10:51Z
• Authors: Amber O. Molnar; Anan Bader Eddeen; Robin Ducharme; Amit X. Garg; Ziv Harel; Megan K. McCallum; Jeffrey Perl; Ron Wald; Deborah Zimmerman; Manish M. Sood
• Keywords: Adult; Male; Kidney; 03 medical and health sciences; 0302 clinical medicine; Atrial Fibrillation; Diseases of the circulatory (Cardiovascular) system; Albuminuria; Humans; atrial fibrillation; Original Research; Aged; Proportional Hazards Models; Ontario; Chi-Square Distribution; Incidence; Middle Aged; Prognosis; 3. Good health; risk factor; RC666-701; Creatinine; Multivariate Analysis; Disease Progression; Female; Kidney Diseases; chronic kidney disease; Biomarkers; Glomerular Filtration Rate

Background Early evidence suggests proteinuria is independently associated with incident atrial fibrillation (AF). We sought to investigate whether the association of AF altered by kidney function. Methods and Results Retrospective cohort study using administrative healthcare databases in Ontario, Canada (2002–2015). A total 736 666 patients aged ≥40 years not receiving dialysis no previous history were included. Proteinuria was defined urine albumin‐to‐creatinine ratio (ACR) function estimated glomerular filtration rate (eGFR). The primary outcome time AF. Cox proportional models used determine hazard for censored death, dialysis, transplant, or end follow‐up. Fine Grey subdistribution AF, death as a competing event. Median follow‐up 6 44 809 developed In adjusted models, ACR eGFR ( P <0.0001). differed based on (ACR × interaction, Overt (ACR, 120 mg/mmol) greater risk intact (eGFR, 120) versus reduced 30) (adjusted ratios, 4.5 [95% CI, 4.0–5.1] 2.6 2.4–2.8], respectively; referent 0 120). similar analyses. Conclusions increases markedly compared those decreased Screening preventative strategies should consider an independent factor