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

Background Early evidence suggests proteinuria is independently associated with incident atrial fibrillation (AF). We sought to investigate whether the association of proteinuria with incident AF is altered by kidney function. Methods and Results Retrospective cohort study using administrative healt...

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Bibliographic Details
Published in:Journal of the American Heart Association 2017-07, Vol.6 (7), p.n/a
Main Authors: Molnar, Amber O., Eddeen, Anan Bader, Ducharme, Robin, Garg, Amit X., Harel, Ziv, McCallum, Megan K., Perl, Jeffrey, Wald, Ron, Zimmerman, Deborah, Sood, Manish M.
Format: Article
Language:English
Subjects:
Adult
Aged
Albuminuria - diagnosis
Albuminuria - epidemiology
Albuminuria - physiopathology
Albuminuria - urine
atrial fibrillation
Atrial Fibrillation - diagnosis
Atrial Fibrillation - epidemiology
Biomarkers - urine
Chi-Square Distribution
chronic kidney disease
Creatinine - urine
Disease Progression
Female
Glomerular Filtration Rate
Humans
Incidence
Kidney - physiopathology
Kidney Diseases - diagnosis
Kidney Diseases - epidemiology
Kidney Diseases - physiopathology
Kidney Diseases - urine
Male
Middle Aged
Multivariate Analysis
Ontario - epidemiology
Original Research
Prognosis
Proportional Hazards Models
Retrospective Studies
Risk Assessment
risk factor
Risk Factors
Time Factors
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Summary:Background Early evidence suggests proteinuria is independently associated with incident atrial fibrillation (AF). We sought to investigate whether the association of proteinuria with incident AF is altered by kidney function. Methods and Results Retrospective cohort study using administrative healthcare databases in Ontario, Canada (2002–2015). A total of 736 666 patients aged ≥40 years not receiving dialysis and with no previous history of AF were included. Proteinuria was defined using the urine albumin‐to‐creatinine ratio (ACR) and kidney function by the estimated glomerular filtration rate (eGFR). The primary outcome was time to AF. Cox proportional models were used to determine the hazard ratio for AF censored for death, dialysis, kidney transplant, or end of follow‐up. Fine and Grey models were used to determine the subdistribution hazard ratio for AF, with death as a competing event. Median follow‐up was 6 years and 44 809 patients developed AF. In adjusted models, ACR and eGFR were associated with AF (P
ISSN:2047-9980
2047-9980
DOI:10.1161/JAHA.117.005685