SORA

Advancing, promoting and sharing knowledge of health through excellence in teaching, clinical practice and research into the prevention and treatment of illness

Management and 1-Year Outcomes of Patients With Newly Diagnosed Atrial Fibrillation and Chronic Kidney Disease: Results From the Prospective GARFIELD - AF Registry.

Goto, S; Angchaisuksiri, P; Bassand, J-P; Camm, AJ; Dominguez, H; Illingworth, L; Gibbs, H; Goldhaber, SZ; Goto, S; Jing, Z-C; et al. Goto, S; Angchaisuksiri, P; Bassand, J-P; Camm, AJ; Dominguez, H; Illingworth, L; Gibbs, H; Goldhaber, SZ; Goto, S; Jing, Z-C; Haas, S; Kayani, G; Koretsune, Y; Lim, TW; Oh, S; Sawhney, JPS; Turpie, AGG; van Eickels, M; Verheugt, FWA; Kakkar, AK; GARFIELD‐AF Investigators, (2019) Management and 1-Year Outcomes of Patients With Newly Diagnosed Atrial Fibrillation and Chronic Kidney Disease: Results From the Prospective GARFIELD - AF Registry. J Am Heart Assoc, 8 (3). e010510. ISSN 2047-9980 https://doi.org/10.1161/JAHA.118.010510
SGUL Authors: Camm, Alan John

[img]
Preview
PDF Published Version
Available under License Creative Commons Attribution Non-commercial.

Download (698kB) | Preview

Abstract

Background Using data from the GARFIELD - AF (Global Anticoagulant Registry in the FIELD -Atrial Fibrillation), we evaluated the impact of chronic kidney disease ( CKD ) stage on clinical outcomes in patients with newly diagnosed atrial fibrillation ( AF ). Methods and Results GARFIELD - AF is a prospective registry of patients from 35 countries, including patients from Asia (China, India, Japan, Singapore, South Korea, and Thailand). Consecutive patients enrolled (2013-2016) were classified with no, mild, or moderate-to-severe CKD , based on the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative guidelines. Data on CKD status and outcomes were available for 33 024 of 34 854 patients (including 9491 patients from Asia); 10.9% (n=3613) had moderate-to-severe CKD , 16.9% (n=5595) mild CKD , and 72.1% (n=23 816) no CKD . The use of oral anticoagulants was influenced by stroke risk (ie, post hoc assessment of CHA 2 DS 2- VAS c score), but not by CKD stage. The quality of anticoagulant control with vitamin K antagonists did not differ with CKD stage. After adjusting for baseline characteristics and antithrombotic use, both mild and moderate-to-severe CKD were independent risk factors for all-cause mortality. Moderate-to-severe CKD was independently associated with a higher risk of stroke/systemic embolism, major bleeding, new-onset acute coronary syndrome, and new or worsening heart failure. The impact of moderate-to-severe CKD on mortality was significantly greater in patients from Asia than the rest of the world ( P=0.001). Conclusions In GARFIELD - AF , moderate-to-severe CKD was independently associated with stroke/systemic embolism, major bleeding, and mortality. The effect of moderate-to-severe CKD on mortality was even greater in patients from Asia than the rest of the world. Clinical Trial Registration URL : http://www.clinicaltrials.gov . Unique identifier: NCT 01090362.

Item Type: Article
Additional Information: © 2019 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Keywords: GARFIELD‐AF registry, atrial fibrillation, chronic kidney disease, outcomes research, registry, GARFIELD‐AF Investigators
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: J Am Heart Assoc
ISSN: 2047-9980
Language: eng
Dates:
DateEvent
5 February 2019Published
24 December 2018Accepted
Publisher License: Creative Commons: Attribution-Noncommercial 4.0
PubMed ID: 30717616
Go to PubMed abstract
URI: http://openaccess.sgul.ac.uk/id/eprint/110635
Publisher's version: https://doi.org/10.1161/JAHA.118.010510

Actions (login required)

Edit Item Edit Item