Mild Renal Dysfunction and Risk of Thromboembolism and Bleeding in Patients with Atrial Fibrillation:The Chinese Atrial Fibrillation Registry Study

作     者：Jingye Li Sitong Li Chao Jiang Jing Du Xueyuan Guo Songnan Li Chenxi Jiang Ribo Tang Caihua Sang Deyong Long Xin Du Jianzeng Dong Changsheng Ma Li Jingye;Li Sitong;Jiang Chao;Du Jing;Guo Xueyuan;Li Songnan;Jiang Chenxi;Tang Ribo;Sang Caihua;Long Deyong;Du Xin;Dong Jianzeng;Ma Changsheng

作者机构：Department of CardiologyBeijing Anzhen HospitalCapital Medical University and National Clinical Research Center for Cardiovascular DiseasesBeijing 100029China Department of CardiologyBeijing Friendship HospitalCapital Medical UniversityBeijing 100050China Beijing Center for Disease Prevention and ControlBeijing 100013China Heart Health Research CentreBeijing 100029China 

出 版 物：《Cardiology Discovery》 (心血管病探索（英文）)

年 卷 期：2021年第1卷第1期

页      面：29-36页

学科分类：1002[医学-临床医学] 10[医学] 

基　　金：supported by the National Key Research and Development Program of China(2016YFC0900901,2016YFC1301002,and 2020YFC2004803) grant from Beijing Municipal Commission of Science and Technology(D171100006817001). 

主　　题：Atrial fibrillation Chronic kidney disease Major bleeding Thromboembolism 

摘      要：Objective:Previous studies indicated that patients with atrial fibrillation(AF)and moderate-to-severe chronic kidney disease(CKD)are at a higher risk of thromboembolism and bleeding during anticoagulation.Whether mild CKD is associated with an increased risk of thromboembolism and bleeding in AF patients remains unknown.This study aimed to evaluate the impact of mild CKD on thromboembolism and major bleeding among patients with AF.Methods:Baseline serum creatinine was available in 17,559 of 25,512 patients enrolled in the China-AF study between August 2011 and December 2018.After excluding those who underwent AF ablation or with moderate-to-severe CKD,7191 non-valvular AF patients(2059 with mild CKD and 5132 with normal renal function)with regular follow-up for at least 6 months were included.Primary outcomes were the time to the first occurrence of thromboembolic and major bleeding events.Results:Over a mean follow-up of(44.4±23.4)months,639 thromboembolism and 231 major bleeding events occurred.The crude incidence rates of thromboembolism were higher in the mild CKD group than that of the normal renal function group(3.0/100 person-years vs.2.2/100 person-years,P0.0001),while the crude incidence rates of major bleeding were comparable between the two groups(1.0/100 person-years vs.0.8/100 person-years,P=0.076).After multivariate analyses,mild CKD was not associated with an increased risk of thromboembolism(HR=1.05,95%CI:0.89-1.25,P=0.547)or major bleeding(HR=1.11,95%CI:0.84–1.47,P=0.476).Conclusions:Mild CKD was not an independent risk factor of thromboembolism or major bleeding in patients with AF.