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Renal Outcomes of Rhythm Control in Patients Recently Diagnosed With Atrial Fibrillation.
Kim, Daehoon; Yang, Pil-Sung; Jang, Eunsun; Yu, Hee Tae; Kim, Tae-Hoon; Uhm, Jae-Sun; Pak, Hui-Nam; Lee, Moon-Hyoung; Lip, Gregory Y H; Sung, Jung-Hoon; Joung, Boyoung.
Afiliação
  • Kim D; Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
  • Yang PS; Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.
  • Jang E; Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
  • Yu HT; Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
  • Kim TH; Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
  • Uhm JS; Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
  • Pak HN; Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
  • Lee MH; Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
  • Lip GYH; Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
  • Sung JH; Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea. Electronic address: atropin5@cha.ac.kr.
  • Joung B; Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: cby6908@yuhs.ac.
Article em En | MEDLINE | ID: mdl-39243258
ABSTRACT

BACKGROUND:

Atrial fibrillation (AF) is associated with impaired renal function and chronic kidney disease (CKD).

OBJECTIVES:

This study assessed the effects of rhythm control on renal function compared with rate control among patients recently diagnosed with AF.

METHODS:

A total of 20,886 patients with AF and available baseline estimated glomerular filtration rate (eGFR) data undergoing rhythm control (antiarrhythmic drugs or ablation) or rate control therapy, initiated within 1 year of AF diagnosis in 2005 to 2015, were identified from the Korean National Health Insurance Service database. The composite outcome of ≥30% decline in eGFR, acute kidney injury, kidney failure, or death from renal or cardiovascular causes was compared with the use of propensity overlap weighting between rhythm or rate control strategies in patients with or without significant CKD (eGFR <60 mL/min/1.73 m2).

RESULTS:

Of the included patients (median age 62 years, 32.7% female), 2,213 (10.6%) had eGFR <60 mL/min/1.73 m2. Among patients with significant CKD, early rhythm control, compared with rate control, was associated with a lower risk of the primary composite outcome (weighted incidence rate 2.77 vs 3.92 per 100 person-years; weighted HR 0.70; 95% CI 0.52-0.95). In patients without significant CKD, there was no difference in the risk of the primary composite outcome between rhythm and rate control groups (weighted incidence rate 3.41 vs 3.21 per 100 person-years; weighted HR 1.06; 95% CI 0.96-1.18). No differences in safety outcomes were found between rhythm and rate control strategies in patients without or with significant CKD.

CONCLUSIONS:

Among patients with AF and CKD, early rhythm control was associated with lower risks of adverse renal outcomes than rate control was.
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Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article