Management and 1-year outcomes of patients with newly diagnosed atrial fibrillation and chronic kidney disease

Results from the prospective garfield-af registry

The GARFIELD-F Investigators

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background-—Using data from the GARFIELD-AF (Global Anticoagulant Registry in the FIELD–Atrial Fibrillation), we evaluated the impact of chronic kidney disease (CKD) stage on clinical outcomes in patients with newly diagnosed atrial fibrillation (AF). Methods and Results-—GARFIELD-AF is a prospective registry of patients from 35 countries, including patients from Asia (China, India, Japan, Singapore, South Korea, and Thailand). Consecutive patients enrolled (2013–2016) were classified with no, mild, or moderate-to-severe CKD, based on the National Kidney Foundation’s Kidney Disease Outcomes Quality Initiative guidelines. Data on CKD status and outcomes were available for 33 024 of 34 854 patients (including 9491 patients from Asia); 10.9% (n=3613) had moderate-to-severe CKD, 16.9% (n=5595) mild CKD, and 72.1% (n=23 816) no CKD. The use of oral anticoagulants was influenced by stroke risk (ie, post hoc assessment of CHA2DS2-VASc score), but not by CKD stage. The quality of anticoagulant control with vitamin K antagonists did not differ with CKD stage. After adjusting for baseline characteristics and antithrombotic use, both mild and moderate-to-severe CKD were independent risk factors for all-cause mortality. Moderate-to-severe CKD was independently associated with a higher risk of stroke/systemic embolism, major bleeding, new-onset acute coronary syndrome, and new or worsening heart failure. The impact of moderate-to-severe CKD on mortality was significantly greater in patients from Asia than the rest of the world (P=0.001). Conclusions-—In GARFIELD-AF, moderate-to-severe CKD was independently associated with stroke/systemic embolism, major bleeding, and mortality. The effect of moderate-to-severe CKD on mortality was even greater in patients from Asia than the rest of the world.

Original languageEnglish
Article numbere010510
JournalJournal of the American Heart Association
Volume8
Issue number3
DOIs
Publication statusPublished - 2019 Jan 1

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Chronic Renal Insufficiency
Atrial Fibrillation
Registries
Anticoagulants
Mortality
Stroke
Embolism
Hemorrhage
Republic of Korea
Vitamin K
Singapore
Kidney Diseases
Thailand
Acute Coronary Syndrome
Quality Control
India
China
Japan
Heart Failure
Guidelines

Keywords

  • Atrial fibrillation
  • Chronic kidney disease
  • GARFIELD-AF registry
  • Outcomes research
  • Registry

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{8d7e4739ca064b19b69b1a704349fe93,
title = "Management and 1-year outcomes of patients with newly diagnosed atrial fibrillation and chronic kidney disease: Results from the prospective garfield-af registry",
abstract = "Background-—Using data from the GARFIELD-AF (Global Anticoagulant Registry in the FIELD–Atrial Fibrillation), we evaluated the impact of chronic kidney disease (CKD) stage on clinical outcomes in patients with newly diagnosed atrial fibrillation (AF). Methods and Results-—GARFIELD-AF is a prospective registry of patients from 35 countries, including patients from Asia (China, India, Japan, Singapore, South Korea, and Thailand). Consecutive patients enrolled (2013–2016) were classified with no, mild, or moderate-to-severe CKD, based on the National Kidney Foundation’s Kidney Disease Outcomes Quality Initiative guidelines. Data on CKD status and outcomes were available for 33 024 of 34 854 patients (including 9491 patients from Asia); 10.9{\%} (n=3613) had moderate-to-severe CKD, 16.9{\%} (n=5595) mild CKD, and 72.1{\%} (n=23 816) no CKD. The use of oral anticoagulants was influenced by stroke risk (ie, post hoc assessment of CHA2DS2-VASc score), but not by CKD stage. The quality of anticoagulant control with vitamin K antagonists did not differ with CKD stage. After adjusting for baseline characteristics and antithrombotic use, both mild and moderate-to-severe CKD were independent risk factors for all-cause mortality. Moderate-to-severe CKD was independently associated with a higher risk of stroke/systemic embolism, major bleeding, new-onset acute coronary syndrome, and new or worsening heart failure. The impact of moderate-to-severe CKD on mortality was significantly greater in patients from Asia than the rest of the world (P=0.001). Conclusions-—In GARFIELD-AF, moderate-to-severe CKD was independently associated with stroke/systemic embolism, major bleeding, and mortality. The effect of moderate-to-severe CKD on mortality was even greater in patients from Asia than the rest of the world.",
keywords = "Atrial fibrillation, Chronic kidney disease, GARFIELD-AF registry, Outcomes research, Registry",
author = "{The GARFIELD-F Investigators} and Shinya Goto and Pantep Angchaisuksiri and Bassand, {Jean Pierre} and {John Camm}, A. and Helena Dominguez and Laura Illingworth and Harry Gibbs and Goldhaber, {Samuel Z.} and Shinichi Goto and Jing, {Zhi Cheng} and Sylvia Haas and Gloria Kayani and Yukihiro Koretsune and Lim, {Toon Wei} and Seil Oh and Sawhney, {Jitendra Pal Singh} and Turpie, {Alexander G.G.} and {van Eickels}, Martin and Verheugt, {Freek W.A.} and Kakkar, {Ajay K.} and Fitzmaurice, {David A.} and Werner Hacke and Mantovani, {Lorenzo G.} and Frank Misselwitz and Pieper, {Karen S.} and Fox, {Keith A.A.} and Gersh, {Bernard J.} and Luciardi, {Hector Lucas} and Marianne Brodmann and Frank Cools and Barretto, {Antonio Carlos Pereira} and Connolly, {Stuart J.} and Alex Spyropoulos and John Eikelboom and Ramon Corbalan and Dayi Hu and Petr Jansky and Nielsen, {J{\~A}¸rn Dalsgaard} and Hany Ragy and Pekka Raatikainen and {Le Heuzey}, {Jean Yves} and Harald Darius and Matyas Keltai and Sanjay Kakkar and Giancarlo Agnelli and Giuseppe Ambrosio and D{\~A}­az, {Carlos Jerjes S{\~A}¡nchez} and {Ten Cate}, Hugo and Dan Atar and Jaemin Shim",
year = "2019",
month = "1",
day = "1",
doi = "10.1161/JAHA.118.010510",
language = "English",
volume = "8",
journal = "Journal of the American Heart Association",
issn = "2047-9980",
publisher = "Wiley-Blackwell",
number = "3",

}

TY - JOUR

T1 - Management and 1-year outcomes of patients with newly diagnosed atrial fibrillation and chronic kidney disease

T2 - Results from the prospective garfield-af registry

AU - The GARFIELD-F Investigators

AU - Goto, Shinya

AU - Angchaisuksiri, Pantep

AU - Bassand, Jean Pierre

AU - John Camm, A.

AU - Dominguez, Helena

AU - Illingworth, Laura

AU - Gibbs, Harry

AU - Goldhaber, Samuel Z.

AU - Goto, Shinichi

AU - Jing, Zhi Cheng

AU - Haas, Sylvia

AU - Kayani, Gloria

AU - Koretsune, Yukihiro

AU - Lim, Toon Wei

AU - Oh, Seil

AU - Sawhney, Jitendra Pal Singh

AU - Turpie, Alexander G.G.

AU - van Eickels, Martin

AU - Verheugt, Freek W.A.

AU - Kakkar, Ajay K.

AU - Fitzmaurice, David A.

AU - Hacke, Werner

AU - Mantovani, Lorenzo G.

AU - Misselwitz, Frank

AU - Pieper, Karen S.

AU - Fox, Keith A.A.

AU - Gersh, Bernard J.

AU - Luciardi, Hector Lucas

AU - Brodmann, Marianne

AU - Cools, Frank

AU - Barretto, Antonio Carlos Pereira

AU - Connolly, Stuart J.

AU - Spyropoulos, Alex

AU - Eikelboom, John

AU - Corbalan, Ramon

AU - Hu, Dayi

AU - Jansky, Petr

AU - Nielsen, Jørn Dalsgaard

AU - Ragy, Hany

AU - Raatikainen, Pekka

AU - Le Heuzey, Jean Yves

AU - Darius, Harald

AU - Keltai, Matyas

AU - Kakkar, Sanjay

AU - Agnelli, Giancarlo

AU - Ambrosio, Giuseppe

AU - Díaz, Carlos Jerjes Sánchez

AU - Ten Cate, Hugo

AU - Atar, Dan

AU - Shim, Jaemin

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background-—Using data from the GARFIELD-AF (Global Anticoagulant Registry in the FIELD–Atrial Fibrillation), we evaluated the impact of chronic kidney disease (CKD) stage on clinical outcomes in patients with newly diagnosed atrial fibrillation (AF). Methods and Results-—GARFIELD-AF is a prospective registry of patients from 35 countries, including patients from Asia (China, India, Japan, Singapore, South Korea, and Thailand). Consecutive patients enrolled (2013–2016) were classified with no, mild, or moderate-to-severe CKD, based on the National Kidney Foundation’s Kidney Disease Outcomes Quality Initiative guidelines. Data on CKD status and outcomes were available for 33 024 of 34 854 patients (including 9491 patients from Asia); 10.9% (n=3613) had moderate-to-severe CKD, 16.9% (n=5595) mild CKD, and 72.1% (n=23 816) no CKD. The use of oral anticoagulants was influenced by stroke risk (ie, post hoc assessment of CHA2DS2-VASc score), but not by CKD stage. The quality of anticoagulant control with vitamin K antagonists did not differ with CKD stage. After adjusting for baseline characteristics and antithrombotic use, both mild and moderate-to-severe CKD were independent risk factors for all-cause mortality. Moderate-to-severe CKD was independently associated with a higher risk of stroke/systemic embolism, major bleeding, new-onset acute coronary syndrome, and new or worsening heart failure. The impact of moderate-to-severe CKD on mortality was significantly greater in patients from Asia than the rest of the world (P=0.001). Conclusions-—In GARFIELD-AF, moderate-to-severe CKD was independently associated with stroke/systemic embolism, major bleeding, and mortality. The effect of moderate-to-severe CKD on mortality was even greater in patients from Asia than the rest of the world.

AB - Background-—Using data from the GARFIELD-AF (Global Anticoagulant Registry in the FIELD–Atrial Fibrillation), we evaluated the impact of chronic kidney disease (CKD) stage on clinical outcomes in patients with newly diagnosed atrial fibrillation (AF). Methods and Results-—GARFIELD-AF is a prospective registry of patients from 35 countries, including patients from Asia (China, India, Japan, Singapore, South Korea, and Thailand). Consecutive patients enrolled (2013–2016) were classified with no, mild, or moderate-to-severe CKD, based on the National Kidney Foundation’s Kidney Disease Outcomes Quality Initiative guidelines. Data on CKD status and outcomes were available for 33 024 of 34 854 patients (including 9491 patients from Asia); 10.9% (n=3613) had moderate-to-severe CKD, 16.9% (n=5595) mild CKD, and 72.1% (n=23 816) no CKD. The use of oral anticoagulants was influenced by stroke risk (ie, post hoc assessment of CHA2DS2-VASc score), but not by CKD stage. The quality of anticoagulant control with vitamin K antagonists did not differ with CKD stage. After adjusting for baseline characteristics and antithrombotic use, both mild and moderate-to-severe CKD were independent risk factors for all-cause mortality. Moderate-to-severe CKD was independently associated with a higher risk of stroke/systemic embolism, major bleeding, new-onset acute coronary syndrome, and new or worsening heart failure. The impact of moderate-to-severe CKD on mortality was significantly greater in patients from Asia than the rest of the world (P=0.001). Conclusions-—In GARFIELD-AF, moderate-to-severe CKD was independently associated with stroke/systemic embolism, major bleeding, and mortality. The effect of moderate-to-severe CKD on mortality was even greater in patients from Asia than the rest of the world.

KW - Atrial fibrillation

KW - Chronic kidney disease

KW - GARFIELD-AF registry

KW - Outcomes research

KW - Registry

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U2 - 10.1161/JAHA.118.010510

DO - 10.1161/JAHA.118.010510

M3 - Article

VL - 8

JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

SN - 2047-9980

IS - 3

M1 - e010510

ER -