Is there association between changes in eGFR value and the risk of permanent type of atrial fibrillation? Analysis of valvular and non-valvular atrial fibrillation population.

BACKGROUND/AIMS There are no data concerning renal function in population with valvular and non-valvular atrial fibrillation (AF). To assess renal function in patients with AF, the association between eGFR and AF perpetuation, in-hospital mortality. METHODS We studied 1523 patients with AF. Patients with chronic kidney disease (CKD) were compared to population with preserved renal function. RESULTS CKD was more frequently observed in patients with valvular AF(p=0.009). In non-valvular AF patients eGFR <60 ml/min./1,73 m2 had more often permanent AF (p<0.0001). In patients with CKD CHA2DS2VASc score was 4.1±1.5 and HAS-BLED score was 2.1±1.2 and it was higher as compared to population with preserved renal function (p<0.0001 vs. p<0.0001). The odds of permanent AF in patients with non-valvular AF and CKD were increased 1.82 times (OR=1.82, p<0.0001, 95% CI:1.46-2.27). The odds of permanent AF in patients with valvular AF and CKD were not significantly increased (OR=1.46, p=0.2,95% CI:0.86-2.5). In non-valvular AF, if eGFR decrease by 10 ml/min, odds of permanent AF are increased by 10% (OR=1.1 p<0.0001, 95% CI 1.05-1.15). In multivariate logistic regression, in non-valvular AF, odds of in-hospital death were higher for patients >75 years old (OR=3.70, p=0.01, 95% CI 1.33-10.28), with CKD (OR=2.61, p=0.03, 95% CI 1.09-6.23). The type of AF had no significant influence on in-hospital mortality(OR=0.71, p=0.45,95% CI 0.30-1.70). CONCLUSIONS CKD is more often observed in patients with valvular AF. In population with non-valvular AF decreased eGFR is associated with permanent type of AF and with higher CHA2DS2VASc and HAS-BLED score. Among valvular AF patients there are no differences in type of AF between patients with and without CKD. There is the correlation between CKD and AF perpetuation but only in non-valvular population.