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- Title
Clinical Significance of Chronic Kidney Disease and Atrial Fibrillation on Morbidity and Mortality in Patients with Acute Myocardial Infarction.
- Authors
Hwang, Hyeon Seok; Park, Mahn-Won; Yoon, Hye Eun; Chang, Yoon Kyung; Yang, Chul Woo; Kim, Suk Young; Cho, Jung Sun; Kim, Chan Joon; Park, Gyung-Min; Park, Chul-Soo; Choi, Yun-Seok; Koh, Yoon-Seok; Lee, Jong Min; Shin, Dong Il; Seo, Suk Min; Jeon, Doo Soo; Moon, Keon Woong; Yoo, Ki Dong; Kim, Hee Yeol; Kim, Dong-Bin
- Abstract
Background/Aims: Atrial fibrillation (AF) often coexists with acute myocardial infarction (AMI), and chronic kidney disease (CKD) is a major risk for AMI. However, the combined impact of CKD and AF on the mortality and morbidity in AMI population has not been determined. Methods: Between January 2004 and December 2009, a total of 4,738 AMI patients were enrolled prospectively. Patients were divided into four groups according to the combined status of CKD and AF. The primary endpoint was a combination of 5-year major adverse cardiac and cerebrovascular events (MACCE). Results: The prevalence of AF was significantly higher in CKD patients than in non-CKD patients (6.76 vs. 3.31%, p < 0.001). The highest cumulative event rate of MACCE and death was observed in patients with both CKD and AF (68.5 and 64.0%), respectively. In multivariable analyses, compared with patients with neither AF nor CKD, hazard ratios (HR) for composite of MACCE were 1.66 (95% CI, 1.14-2.41), 1.24 (95% CI, 1.06-1.46), and 2.10 (95% CI, 1.42-3.13) for patients with AF only, those with CKD only, and those with both CKD and AF, respectively (p for interaction = 0.935). Patients with both CKD and AF had a greatest risk for all-cause mortality (HR 2.54; 95% CI, 1.60-4.53), and the significant synergistic interaction was observed between CKD and AF (p for interaction = 0.015). Conclusion: The combined effect of AF and CKD on the risk of MACCE after an AMI is stronger than any separate condition, and it confers a synergistic effect on the all-cause mortality risk. © 2014 S. Karger AG, Basel
- Publication
American Journal of Nephrology, 2014, Vol 40, Issue 4, p345
- ISSN
0250-8095
- Publication type
Article
- DOI
10.1159/000368422