Risk of Thromboembolic Events in Atrial Fibrillation With Chronic Kidney Disease. Issue 1 (January 2015)

• Record Type: Journal Article
• Authors: Zeng, Wu-Tao; Sun, Xiu-Ting; Tang, Kai; Mei, Wei-Yi; Liu, Li-Juan; Xu, Qing; Cheng, Yun-Jiu
• Is Part Of: Stroke. Volume 46:Issue 1(2015)
• Publication Date: 2015-01
• Subjects: Cerebrovascular disease -- Periodicals; Cerebral circulation -- Periodicals; 616.81
• DOI: 10.1161/STROKEAHA.114.006881
• Languages: English
• ISSNs: 0039-2499

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Background and Purpose—</title> <p>Chronic kidney disease may increase the risk for ischemic stroke or systemic embolism in patients with nonvalular atrial fibrillation (AF). We conducted a meta-analysis to summarize all published studies to investigate the link between chronic kidney disease and risk of thromboembolic events in AF.</p> </sec> <sec> <title>Methods—</title> <p>We performed a literature search using MEDLINE (source PubMed, 1966 to July, 2014) and EMBASE (1980 to July 2014) with no restrictions. Pooled effect estimates were obtained by using random-effects meta-analysis.</p> </sec> <sec> <title>Results—</title> <p>Eighteen studies involving 538 479 patients and 41 719 incident thromboembolic events were identified. From the pooled analysis, AF patients with estimated glomerular filtration rate <60 mL/min compared with those with estimated glomerular filtration rate ≥60 mL/min experienced a significantly increased risk for developing thromboembolic events (relative risk, 1.62 [95% confidence interval, 1.40–1.87; <italic>P</italic><0.001]). The annual rate of thromboembolic events increased by 0.41% (95% confidence interval, 0.17%–0.65%) for a 10 mL/min decrease in renal function. Addition of renal impairment to CHADS<sub>2</sub> slightly improved the stroke risk stratification.</p> </sec> <sec> <title>Conclusions—</title> <p>Impaired renal function is an independent predictor of stroke or systemic embolism in patients with nonvalvular AF. Consideration of renal function may improve stroke risk stratification in patients with AF.</p> </sec> </abstract>