6533b820fe1ef96bd127a40a
RESEARCH PRODUCT
Brain and kidney, victims of atrial microembolism in elderly hospitalized patients? Data from the REPOSI study
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MaleSettore MED/09 - Medicina InternaREPOSI studyKidneyDisability EvaluationRetrospective StudieRisk Factorshospitalized patientAtrial Fibrillation80 and overOdds RatioLS4_4Renal InsufficiencyChronicMultivariate AnalysiStrokeAged 80 and overMedicine (all)BrainAtrial fibrillationStrokeFemaleatrial microembolismHumanGlomerular Filtration Ratemedicine.medical_specialtySocio-culturaleRenal functionelderlyCognition DisorderInternal medicineThromboembolismmedicineInternal MedicineHumansRenal insufficiency chronicHeart AtriaIntensive care medicineAged; Anticoagulants; Atrial fibrillation; Dementia; Renal insufficiency chronic; Stroke; Aged; Aged 80 and over; Anticoagulants; Atrial Fibrillation; Brain; Cognition Disorders; Dementia; Disability Evaluation; Female; Glomerular Filtration Rate; Heart Atria; Humans; Kidney; Male; Multivariate Analysis; Odds Ratio; Renal Insufficiency Chronic; Retrospective Studies; Risk Factors; Stroke; ThromboembolismAgedRetrospective Studiesbusiness.industryRisk FactorSettore MED/09 - MEDICINA INTERNAAnticoagulantAnticoagulantsRetrospective cohort studyOdds ratiomedicine.diseaseAtrial fibrillationBlood pressureHeart failureMultivariate AnalysisAged Anticoagulants Atrial fibrillation Dementia Renal insufficiency chronic Stroke.Aged; Anticoagulants; Atrial fibrillation; Dementia; Renal insufficiency chronic; Strokeatrial microembolism; elderly; hospitalized patients; REPOSI study;DementiabusinessCognition DisordersKidney diseaseAged; Anticoagulants; Atrial fibrillation; Dementia; Renal insufficiency chronic; Stroke; Aged; Aged 80 and over; Anticoagulants; Atrial Fibrillation; Brain; Cognition Disorders; Dementia; Disability Evaluation; Female; Glomerular Filtration Rate; Heart Atria; Humans; Kidney; Male; Multivariate Analysis; Odds Ratio; Renal Insufficiency Chronic; Retrospective Studies; Risk Factors; Stroke; Thromboembolism; Internal Medicine; Medicine (all)description
Abstract Background It is well known that atrial fibrillation (AF) and chronic kidney disease (CKD) are associated with a higher risk of stroke, and new evidence links AF to cognitive impairment, independently from an overt stroke (CI). Our aim was to investigate, assuming an underlying role of atrial microembolism, the impact of CI and CKD in elderly hospitalized patients with AF. Methods We retrospectively analyzed the data collected on elderly patients in 66 Italian hospitals, in the frame of the REPOSI project. We analyzed the clinical characteristics of patients with AF and different degrees of CI. Multivariate logistic analysis was used to explore the relationship between variables and mortality. Results Among the 1384 patients enrolled, 321 had AF. Patients with AF were older, had worse CI and disability and higher rates of stroke, hypertension, heart failure, and CKD, and less than 50% were on anticoagulant therapy. Among patients with AF, those with worse CI and those with lower estimated glomerular filtration rate (eGFR) had a higher mortality risk (odds ratio 1.13, p = 0.006). Higher disability levels, older age, higher systolic blood pressure, and higher eGFR were related to lower probability of oral anticoagulant prescription. Lower mortality rates were found in patients on oral anticoagulant therapy. Conclusions Elderly hospitalized patients with AF are more likely affected by CI and CKD, two conditions that expose them to a higher mortality risk. Oral anticoagulant therapy, still underused and not optimally enforced, may afford protection from thromboembolic episodes that probably concur to the high mortality.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2015-01-01 |