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. 2021 Sep;25(9):638-645.
doi: 10.5152/AnatolJCardiol.2021.35332.

Impact of kidney function on the occurrence of new-onset atrial fibrillation in patients with ST-elevation myocardial infarction

Lidija Savic  1 , Igor Mrdovic  1 , Milika Asanin  1 , Sanja Stankovic  2 , Gordana Krljanac  1 , Ratko Lasica  1 , Mihajlo Viduljevic  1
Affiliations

Impact of kidney function on the occurrence of new-onset atrial fibrillation in patients with ST-elevation myocardial infarction

Lidija Savic et al. Anatol J Cardiol. 2021 Sep.

Abstract

Objective: In this study, we aimed to examine the prognostic impact of decreased kidney function at admission on the occurrence of new-onset atrial fibrillation (AF) in patients with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI).

Methods: The study enrolled 3,115 consecutive patients with STEMI. Kidney function was assessed by estimation of the glomerular filtration rate (eGFR) at admission. Patients with cardiogenic shock at admission, patients on hemodialysis, and patients with a medical history of previous AF (paroxysmal, persistent, or permanent) were excluded. The follow-up period was six years.

Results: New-onset AF occurred in 215 (6.9%) patients, 75 (34.9%) patients presented with AF, and 140 (65.1%) patients developed AF after pPCI. The median time of AF occurrence in patients who did not present with AF was 4.5 (interquartile range 1-25) hours after pPCI. New-onset AF was associated with a higher short- and long-term mortality. In the multiple logistic regression analysis, all stages of reduced kidney function were independent predictors for the occurrence of new-onset AF, and negative prognostic impact increased with the deterioration of kidney function: eGFR <90 mL/min/m2, hazard ratio (HR) 1.96, 95% confidence interval (CI) 1.42-2.89, p=0.011; eGFR 60-89 mL/min/m2, HR 1.54, 95% CI 1.13-2.57, p=0.045; eGFR 45-59 mL/min/m2-, HR 2.09, 95% CI 1.24-2.85, p=0.023; eGFR 30-44 mL/min/m2-, HR 2.93, 95% CI 1.64-5.29, p<0.001; eGFR 15-29 mL/min/m2-, HR 5.51, 95% CI 2.67-11.39, p<0.001.

Conclusion: Decreased kidney function was significantly associated with the occurrence of new-onset AF, and its impact increased with the deterioration in kidney function, starting with an eGFR value of 90 mL/min/m2. New-onset AF was an independent predictor of long-term all-cause mortality in the analyzed patients.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Kaplan-Meier curves showing mortality during six-year follow-up according to the development of new-onset atrial fibrillation
Figure 2
Figure 2
Receiver operating characteristic curve for estimated glomerular filtration rate
See this image and copyright information in PMC

References

    1. Cosentino N, Ballarotto M, Campodonico J, Milazzo V, Bonomi A, Genovesi S, et al. Impact of Glomerular Filtration Rate on the Incidence and Prognosis of New-Onset Atrial Fibrillation in Acute Myocardial Infarction. J Clin Med. 2020;9:1396. doi: 10.3390/jcm9051396. - DOI - PMC - PubMed
    1. Şerban RC, Şuş I, Lakatos EK, Demjen Z, Ceamburu A, Fişcă PC, et al. Chronic kidney disease predicts atrial fibrillation in patients with ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention. Acta Cardiol. 2019;74:472–9. doi: 10.1080/00015385.2018.1521558. - DOI - PubMed
    1. Gorenek B, Kudaiberdieva G. Atrial fibrillation in acute ST-elevation myocardial infarction: clinical and prognostic features. Curr Cardiol Rev. 2012;8:281–9. doi: 10.2174/157340312803760857. - DOI - PMC - PubMed
    1. Mrdovic I, Savic L, Krljanac G, Perunicic J, Asanin M, Lasica R, et al. Incidence, predictors, and 30-day outcomes of new-onset atrial fibrillation after primary percutaneous coronary intervention: insight into the RISK-PCI trial. Coron Artery Dis. 2012;23:1–8. doi: 10.1097/MCA.0b013e32834df552. - DOI - PubMed
    1. Congo KH, Belo A, Carvalho J, Neves D, Guerreiro R, Pais JA, et al. New-Onset Atrial Fibrillation in St-Segment Elevation Myocardial Infarction: Predictors and Impact on Therapy And Mortality. Arq Bras Cardiol. 2019;113:948–57. doi: 10.5935/abc.20190190. - DOI - PMC - PubMed

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