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RESEARCH PRODUCT
Relationship between low Ankle-Brachial Index and rapid renal function decline in patients with atrial fibrillation: a prospective multicentre cohort study.
In Patients With Atrial Fibrillation: A. Prospective Multicentre Cohort Study Francesco VioliDaniele PastoriFrancesco PerticoneWilliam R. HiattAngela SciacquaStefania BasiliMarco ProiettiGino R. CorazzaGregory Y. H. LipPasquale PignatelliCominacini LMozzini CDe Palma DGalderisi MCudemo GGalletti FFazio VLuigi Elio AdinolfiSellitto ARestivo LCacciafesta MGueli NCastellino PCurto IVecchio CSesti GArturi FGrembiale APerticone FScarpino PeCarullo GVidili GAtzori SDelitala GDi Michele DFava ABertolotti MMussi CDe Luca EDe Zaiacomo FGiantin VCorazza Gino RMiceli EPadula DSantovito DCipollone FAndreozzi PEttorre EViscogliosi GGlorioso NMelis GMarras GMatta MPorta MBrizzi MfMoroni CValente LLopreiato FGentile ACatozzo VRancan EAgeno WGuasti LCangemi RPignataro FsPastori DFerro DLoffredo LPerri LCatasca ERaparelli VNapoleone LTommaso BFrancesco BTalerico GCalvieri CVicario TRusso RSaliola MDel Ben MAngelico FVestri ArFarcomeni ADi Tanna GDavi GBasili SMannucci PmPerticone FLip GyHiatt WVestri ArCorazza GrLicata GVioli FGobbi PBasili SCorrao S.subject
RegistrieMaleAnkle brachial index atrial fibrillation renal functionCross-sectional studyAngiotensin-Converting Enzyme InhibitorsBlood PressureCardiovascular Medicineurologic and male genital diseasesKidneyRisk FactorsAtrial FibrillationOdds RatioSurveys and Questionnaireatrial fibrillation1506Prospective StudiesRenal InsufficiencyPractice Patterns Physicians'Prospective cohort studyMedicine (all)Atrial fibrillationGeneral MedicineMiddle Agedmedicine.anatomical_structureItalyHypertensioncardiovascular systemCardiologyDisease ProgressionFemaleVitamin K antagonistABICohort studyHumanGlomerular Filtration RateAnkle brachial index; atrial fibrillation; renal function1683medicine.medical_specialtyLogistic ModelNon-Vitamin K oral anticoagulantRenal functionrenal function declineAnkle-Brachial IndexNOInternal medicineAged; Angiotensin-Converting Enzyme Inhibitors; Atrial Fibrillation; Cross-Sectional Studies; Disease Progression; Female; Humans; Hypertension; Italy; Kidney; Logistic Models; Male; Middle Aged; Odds Ratio; Prospective Studies; Renal Insufficiency; Risk Factors; Ankle Brachial Index; Blood Pressure; Glomerular Filtration Rate; Medicine (all)medicineInternal MedicineHumansAnkle Brachial Indexcardiovascular diseasesIntensive care medicineAgedCross-Sectional StudieAntithrombotic therapybusiness.industryRisk FactorResearchrenal functionAnticoagulantAngiotensin-Converting Enzyme InhibitorOdds ratiomedicine.diseasebody regionsProspective StudieBlood pressureAtrial fibrillation; Ankle-Brachial Index; renal function declineCross-Sectional StudiesLogistic ModelsAnklebusinessABI renal function atrial fibrillationdescription
Objective: To investigate the relationship between Ankle-Brachial Index (ABI) and renal function progression in patients with atrial fibrillation (AF). Design: Observational prospective multicentre cohort study. Setting: Atherothrombosis Center of I Clinica Medica of 'Sapienza' University of Rome; Department of Medical and Surgical Sciences of University Magna Græcia of Catanzaro; Atrial Fibrillation Registry for Ankle-Brachial Index Prevalence Assessment-Collaborative Italian Study. Participants: 897 AF patients on treatment with vitamin K antagonists. Main outcome measures: The relationship between basal ABI and renal function progression, assessed by the estimated Glomerular Filtration Rate (eGFR) calculated with the CKD-EPI formula at baseline and after 2 years of follow-up. The rapid decline in eGFR, defined as a decline in eGFR >5 mL/min/1.73 m2 /year, and incident eGFR2 were primary and secondary end points, respectively. Results: Mean age was 71.8±9.0 years and 41.8% were women. Low ABI (ie, ≤0.90) was present in 194 (21.6%) patients. Baseline median eGFR was 72.7 mL/min/1.73 m2, and 28.7% patients had an eGFR2. Annual decline of eGFR was -2.0 (IQR -7.4/-0.4) mL/min/1.73 m2/year, and 32.4% patients had a rapid decline in eGFR. Multivariable logistic regression analysis showed that ABI ≤0.90 (OR 1.516 (95% CI 1.075 to 2.139), p=0.018) and arterial hypertension (OR 1.830 95% CI 1.113 to 3.009, p=0.017) predicted a rapid eGFR decline, with an inverse association for angiotensin converting enzyme (ACE) inhibitors/angiotensin receptor blockers (OR 0.662 95% CI 0.464 to 0.944, p=0.023). Among the 639 patients with AF with eGFR >60 mL/min/1.73 m2, 153 (23.9%) had a reduction of the eGFR 2. ABI ≤0.90 was also an independent predictor for incident eGFR2 (HR 1.851, 95% CI 1.205 to 2.845, p=0.005). Conclusions: In patients with AF, an ABI ≤0.90 is independently associated with a rapid decline in renal function and incident eGFR2. ABI measurement may help identify patients with AF at risk of renal function deterioration. Trial registration number: NCT01161251.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2015-05-01 |