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Impact of creatinine clearance on outcomes in patients with non-valvular atrial fibrillation: a subanalysis of the J-RHYTHM Registry.


ABSTRACT:

Aims

To clarify the influence of renal function on adverse outcomes in patients with non-valvular atrial fibrillation (NVAF), a post hoc analysis of the J-RHYTHM Registry was performed.

Methods and results

A consecutive series of outpatients with atrial fibrillation (AF) were enrolled from 158 institutions and followed for 2?years or until the occurrence of an event. Among 7406 patients with non-valvular AF, 6052 patients (69.8?±?10.0?years, 71.2% men) with creatinine clearance (CrCl) value at baseline were divided into four groups according to CrCl level (<30, 30-49.9, 50-79.9, and??80?mL/min). Patients with CrCl?<80?mL/min showed increased incidence of thromboembolism, major haemorrhage, all-cause and cardiovascular death, and composite events as compared with patients with CrCl??80?mL/min. After adjustment for multiple confounders, lower CrCl values emerged as independent predictors for thromboembolism [CrCl 30-49.9, hazard ratio (HR) 2.27, 95% confidence interval (CI) 1.09-4.72, P?=?0.029; and CrCl 50-79.9, HR 1.99, 95% CI 1.07-3.72, P?=?0.030] and all-cause death (CrCl?<30, HR 6.44, 95% CI 3.03-13.7, P?ConclusionRenal impairment was an independent predictor of adverse clinical outcomes except for major haemorrhage in Japanese patients with non-valvular AF. Warfarin was associated with lower rates of composite events in patients with lower CrCl values.

Clinical trial registration

http://www.umin.ac.jp/ctr/. Unique identifier: UMIN000001569.

SUBMITTER: Kodani E 

PROVIDER: S-EPMC5862022 | biostudies-literature | 2018 Jan

REPOSITORIES: biostudies-literature

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Impact of creatinine clearance on outcomes in patients with non-valvular atrial fibrillation: a subanalysis of the J-RHYTHM Registry.

Kodani Eitaro E   Atarashi Hirotsugu H   Inoue Hiroshi H   Okumura Ken K   Yamashita Takeshi T   Origasa Hideki H  

European heart journal. Quality of care & clinical outcomes 20180101 1


<h4>Aims</h4>To clarify the influence of renal function on adverse outcomes in patients with non-valvular atrial fibrillation (NVAF), a post hoc analysis of the J-RHYTHM Registry was performed.<h4>Methods and results</h4>A consecutive series of outpatients with atrial fibrillation (AF) were enrolled from 158 institutions and followed for 2 years or until the occurrence of an event. Among 7406 patients with non-valvular AF, 6052 patients (69.8 ± 10.0 years, 71.2% men) with creatinine clearance (C  ...[more]

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