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Dong Z, Du X, Lu S, Jiang C, Xia S, He L, Su X, Jia Z, Long D, Sang C, Tang R, Liu N, Bai R, Yu R, Dong J, Ma C. Incidence and predictors of hospitalization in patients with atrial fibrillation: results from the Chinese atrial fibrillation registry study. BMC Cardiovasc Disord 2021; 21:146. [PMID: 33740910 PMCID: PMC7980549 DOI: 10.1186/s12872-021-01951-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 03/09/2021] [Indexed: 12/12/2022] Open
Abstract
Background Patients with atrial fibrillation (AF) underwent a high risk of hospitalization, which has not been paid much attention to in practice. Therefore, we aimed to assess the incidence, causes and predictors of hospitalization in AF patients. Methods From August 2011 to December 2017, a total number of 20,172 AF patients from the Chinese Atrial Fibrillation Registry (China-AF) Study were prospectively selected for this study. We described the incidence, causes of hospitalization by age groups and sex. The Fine-Gray competing risk model was employed to identify predictors of first all-cause and first cause-specific hospitalization. Results After a mean follow-up of 37.3 ± 20.4 months, 7,512 (37.2%) AF patients experienced one or more hospitalizations. The overall incidence of all-cause hospitalization was 24.0 per 100 patient-years. Patients aged < 65 years were predominantly hospitalized for AF (42.1% of the total hospitalizations); while patients aged 65–74 and ≥ 75 years were mainly hospitalized for non-cardiovascular diseases (43.6% and 49.3%, respectively). We found patients complicated with heart failure (HF)[hazard ratio (HR) 1.10, 95% confidence interval (CI) 1.02–1.18], established coronary artery disease (CAD) (HR 1.24, 95%CI 1.17–1.33), ischemic stroke/transient ischemic attack (TIA) (HR 1.22, 95%CI 1.15–1.30), diabetes (HR 1.14, 95%CI 1.08–1.20), chronic obstructive pulmonary disease (COPD) (HR 1.28, 95%CI 1.02–1.62), gastrointestinal disorder (HR 1.37, 95%CI 1.21–1.55), and renal dysfunction (HR 1.24, 95%CI 1.09–1.42) had higher risks of hospitalization. Conclusions More than one-third of AF patients included in this study were hospitalized at least once during over 3-year follow-up. The main cause for hospitalization among the elderly patients (≥ 65 years) is non-cardiovascular diseases rather than AF. Multidisciplinary management of comorbidities should be advocated to reduce hospitalization in AF patients older than 65 years old. Clinical Registryhttp://www.chictr.org.cn/showproj.aspx?proj=5831. Unique identifier: ChiCTR-OCH-13003729. The registration date is October 22, 2013. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-021-01951-5.
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Affiliation(s)
- Zhaojie Dong
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, 100029, People's Republic of China
| | - Xin Du
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, 100029, People's Republic of China. .,Heart Health Research Center, Beijing, People's Republic of China. .,The George Inst itute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia.
| | - Shangxin Lu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, 100029, People's Republic of China
| | - Chao Jiang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, 100029, People's Republic of China
| | - Shijun Xia
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, 100029, People's Republic of China
| | - Liu He
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, 100029, People's Republic of China
| | - Xin Su
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, 100029, People's Republic of China
| | - Zhaoxu Jia
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, 100029, People's Republic of China
| | - Deyong Long
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, 100029, People's Republic of China
| | - Caihua Sang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, 100029, People's Republic of China
| | - Ribo Tang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, 100029, People's Republic of China
| | - Nian Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, 100029, People's Republic of China
| | - Rong Bai
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, 100029, People's Republic of China
| | - Ronghui Yu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, 100029, People's Republic of China
| | - Jianzeng Dong
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, 100029, People's Republic of China
| | - Changsheng Ma
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, 100029, People's Republic of China.
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Ni Z, Liang Y, Xie N, Liu J, Sun G, Chen S, Ye J, He Y, Guo W, Tan N, Chen J, Liu Y, Chen Z, Wang S. Simple pre-procedure risk stratification tool for contrast-induced nephropathy. J Thorac Dis 2019; 11:1597-1610. [PMID: 31179104 DOI: 10.21037/jtd.2019.04.69] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background A few simple and pre-procedural risk models have been developed for predicting contrast-induced nephropathy (CIN), which allow for early administration of preventative strategies before coronary angiography (CAG). The study aims to develop and validate simple pre-procedure tools for predicting risk of CIN following CAG. Methods We retrospectively analyzed the data from 3,469 consecutive patients undergoing CAG, who were randomly assigned to a development dataset (n=2,313) and a validation dataset (n=1,156). CIN was defined as an increase in serum creatinine (SCr) ≥0.5 mg/dL from baseline within 72 hours after CAG. Multivariate logistic regression was applied to identify independent predictors of CIN to develop risk models. The possible predictors included age >75 years, hypotension, acute myocardial infarction (AMI), SCr ≥1.5 mg/dL, and congestive heart failure (CHF). Results The incidences of CIN were 3.20% and 3.55% in the training and validation dataset respectively. Compared to classical Mehran' and ACEF CIN risk score, the new score across the validation dataset exhibited similar discrimination and predictive ability on CIN (c-statistic: 0.829, 0.832, 0.812 respectively) and in-hospital mortality (c-statistic: 0.909, 0.937, 0.866 respectively) (all P>0.05). Conclusions The easy-to-use pre-procedural prediction model only containing 5 factors had similar predictive ability on CIN and mortality.
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Affiliation(s)
- Zhonghan Ni
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Yan Liang
- Department of Cardiology, Maoming People's Hospital, Maoming 525000, China
| | - Nianjin Xie
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Jin Liu
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Guoli Sun
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Shiqun Chen
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Jianfeng Ye
- Department of Cardiology, Dongguan People's Hospital, Dongguan 523059, China
| | - Yibo He
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Wei Guo
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Ning Tan
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Jiyan Chen
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Yong Liu
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Zhujun Chen
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Shouhong Wang
- Department of Critical Care Medicine, Guangdong Geriatric Institute, Guangdong Provincial People's Hospital and Guangdong Academy of Medical Sciences, Guangzhou 510080, China
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Prasitlumkum N, Kanitsoraphan C, Kittipibul V, Rattanawong P, Chongsathidkiet P, Cheungpasitporn W. Baseline atrial fibrillation is associated with contrast-induced nephropathy after cardiac catheterization in coronary artery disease: Systemic review and meta-analysis. Clin Cardiol 2018; 41:1555-1562. [PMID: 30328129 DOI: 10.1002/clc.23100] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 10/03/2018] [Accepted: 10/13/2018] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Atrial fibrillation (AF) is the most common arrhythmia, independently associated with significant mortality and morbidity. Recent studies suggest that AF is potentially associated with contrast-induced nephropathy (CIN) in patients with coronary artery disease (CAD) undergoing catheterization. However, the association was not conclusive. Thus, we assessed the association between AF in patients with CAD and CIN by a systematic review of the literature and a meta-analysis. HYPOTHESIS AF is a predictor of CIN in patients with CAD. METHODS We comprehensively searched the databases of MEDLINE and EMBASE from inception to April 2018. Included studies were published observational studies that compared the risk of CIN among CAD patients with AF vs those without AF. Data from each study were combined using the random-effects, generic inverse variance method of DerSimonian and Laird to calculate risk ratios and 95% confidence intervals (CIs). RESULTS Eight cohort studies from June 2007 to November 2017 were included in this meta-analysis involving 16,691 subjects with CAD (1,030 with AF and 15,661 without its presence). The presence of AF was associated with CIN (pooled risk ratio = 2.17, 95% CI: 1.50-3.14, P < 0.001, I2 = 54.1%). In our subgroup analysis by urgency and multivariable adjustment, both groups still showed substantial association between AF and CIN (P < 0.05). CONCLUSIONS AF increased the risk of CIN up to two fold among patients with CAD compared to the absence of it. Our study suggests that the presence of AF in CAD is prognostic for the development of CIN.
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Affiliation(s)
- Narut Prasitlumkum
- Department of Internal Medicine, University of Hawaii Internal Medicine Residency Program, Honolulu, Hawaii
| | - Chanavuth Kanitsoraphan
- Department of Internal Medicine, University of Hawaii Internal Medicine Residency Program, Honolulu, Hawaii.,Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Veraprapas Kittipibul
- Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Department of Internal Medicine, Jackson Memorial Hospital Internal Medicine Residency Program, Miami, Florida
| | - Pattara Rattanawong
- Department of Internal Medicine, University of Hawaii Internal Medicine Residency Program, Honolulu, Hawaii.,Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | | | - Wisit Cheungpasitporn
- Department of Nephrology, University of Mississippi Medical Center, Jackson, Mississippi
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Ashish K, Bandyopadhyay D, Ghosh RK, Tan JL, Bose S. An intriguing relation between atrial fibrillation and contrast-induced nephropathy. IJC HEART & VASCULATURE 2018; 21:78-79. [PMID: 30377653 PMCID: PMC6202793 DOI: 10.1016/j.ijcha.2018.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Accepted: 10/16/2018] [Indexed: 10/31/2022]
Affiliation(s)
| | | | - Raktim K Ghosh
- MetroHealth, Case Western Reserve University, Cleveland, OH, USA
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Bermuda Triangle: Chronic kidney disease, contrast-induced nephropathy, and atrial fibrillation. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2018; 19:71. [DOI: 10.1016/j.carrev.2017.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 06/02/2017] [Indexed: 11/20/2022]
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Contrast-Induced Nephropathy After Cardiac Catheterization: Culprits, Consequences and Predictors. Am J Med Sci 2017; 354:462-466. [DOI: 10.1016/j.amjms.2017.05.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 05/19/2017] [Accepted: 05/22/2017] [Indexed: 11/17/2022]
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Elserafy AS. The Bermuda triangle: Chronic kidney disease, contrast-induced nephropathy, and atrial fibrillation. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2017; 19:72-74. [PMID: 29033366 DOI: 10.1016/j.carrev.2017.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 08/24/2017] [Accepted: 08/29/2017] [Indexed: 11/15/2022]
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Düzel B, Emren SV, Berilgen R. Effect of Atrial Fibrillation on Contrast-Induced Nephropathy Development in Patients With Non-ST-Segment Elevation Myocardial Infarction. Angiology 2017; 68:871-876. [DOI: 10.1177/0003319717699328] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We investigated the relationship between atrial fibrillation (AF) and contrast-induced nephropathy (CIN) in patients with non-ST-segment elevation myocardial infarction (NSTEMI); 1045 consecutive patients undergoing percutaneous coronary interventions were enrolled. Risk factors for CIN were investigated. Baseline characteristics, except oral anticoagulant use, were similar between patients with and without AF. Patients with CIN show higher presence of diabetes mellitus (DM), coronary artery bypass graft surgery history, Mehran score, baseline creatinine levels, baseline glomerular filtration rate (GFR), peak troponin levels, left ventricular ejection fraction (LVEF), and presence of AF ( P < .05). In multivariate logistic regression analyses, the presence of DM (odds ratio [OR], 2.333; 95% confidence interval [CI], 1.222-4.457; P = .010), Mehran score (OR, 1.269; 95% CI, 1.152-1.398; P < .001), baseline GFR (OR, 0,954; 95% CI, 0.944-0.964 P < .001), left anterior descending artery originated infarction (OR, 1.594; 95% CI, 1.061-2.398; P = .025), LVEF value (OR, 0.956; 95% CI, 0.926-0.986; P = .005), and the presence of AF (OR, 3.830; 95% CI, 1.239-11.839; P = .020) were independent predictors of CIN. Atrial fibrillation can be related to CIN development in patients with NSTEMI.
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Affiliation(s)
- Bariş Düzel
- Department of Cardiology, Mersin State Hospital, Mersin, Turkey
| | - Sadik Volkan Emren
- Department of Cardiology, Afyonkarahisar State Hospital, Afyonkarahisar, Turkey
| | - Rida Berilgen
- Department of Cardiology, Egepol Hospital, Izmir, Turkey
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Marín F, Anguita-Sánchez M, Sanmartín M. Direct oral anticoagulants and cardiovascular prevention in patients with nonvalvular atrial fibrillation. Expert Opin Pharmacother 2016; 18:67-77. [PMID: 27924633 DOI: 10.1080/14656566.2016.1267140] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Patients with atrial fibrillation have an increased risk for stroke, systemic embolism and cardiovascular events, including myocardial infarction and cardiovascular death. However, the majority of studies that have analyzed the efficacy of anticoagulants have been focused only on their effects on the risk of stroke. Areas covered: The available evidence about the association between atrial fibrillation and cardiovascular disease as well as the effects of oral anticoagulation on cardiovascular death and myocardial infarction, with a particular focus on direct oral anticoagulants, was updated in this review. Expert opinion: The management of patients with atrial fibrillation should not be limited to the prevention of stroke, but should also include the prevention of cardiovascular events. Despite treatment with vitamin K antagonists, many patients with atrial fibrillation still develop cardiovascular complications, particularly individuals whose anticoagulation is difficult to control. Direct oral anticoagulants overcome the majority of limitations of vitamin K antagonists and compared with warfarin, they lead to a greater reduction in the risk of stroke or systemic embolism, all-cause mortality, and intracranial hemorrhage. Although these drugs can only be compared indirectly, it seems that not all direct oral anticoagulants are equal with regard to the prevention of myocardial infarction.
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Affiliation(s)
- Francisco Marín
- a Department of Cardiology , Hospital Universitario Virgen de la Arrixaca, IMIB-Arrixaca , Murcia , Spain
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