title: Impact of renal dysfunction on clinical outcome in patients with low risk of atrial fibrillation.
abstract: BACKGROUND
  The impact of renal dysfunction has been investigated in patients with non-valvular atrial fibrillation (AF). The aim of this study was to assess its additive prognostic value in low thromboembolic risk AF patients with CHA2DS2-VASc score 0-1.
  
  
  RESULTS
  A total of 617 non-valvular AF patients were enrolled and baseline serum creatinine was measured. Estimated glomerular filtration rate and estimated clearance of creatinine were calculated using the Modification of Diet in Renal Disease equation and Cockcroft-Gault formula, respectively. The primary endpoint was cardiovascular death and systemic thromboembolic events, including acute ischemic stroke, transient ischemic attack, and peripheral artery embolism. Of these, 338 individuals had clinical CHA2DS2-VASc score 0-1. Among these individuals, 23 patients had impaired renal function. During the follow-up period of 53.6±32.1 months, the annual composite outcome rate in AF patients with CHA2DS2-VASc score 0-1 was 0.40%/year. As compared with patients with preserved renal function, the annual composite outcome rate was significantly higher in patients with impaired renal function (2.92%/year vs. 0.21%/year, P<0.001). Moreover, on multivariate Cox regression analysis, renal dysfunction was the only risk predictor in these low-risk patients.
  
  
  CONCLUSIONS
  Impaired renal function has an additive prognostic value for thromboembolic events and cardiovascular mortality in low-risk AF patients with CHA2DS2-VASc score 0-1.
authors: Division of Cardiology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center.
authors: Wen-Yu
authors: WY
authors: Lin
authors: Yenn-Jiang
authors: YJ
authors: Lin
authors: Fa-Po
authors: FP
authors: Chung
authors: Tze-Fan
authors: TF
authors: Chao
authors: Jo-Nan
authors: JN
authors: Liao
authors: Shih-Lin
authors: SL
authors: Chang
authors: Li-Wei
authors: LW
authors: Lo
authors: Yu-Feng
authors: YF
authors: Hu
authors: Chern-En
authors: CE
authors: Chiang
authors: Shu-Meng
authors: SM
authors: Cheng
authors: Wei-Shiang
authors: WS
authors: Lin
authors: Shih-Ann
authors: SA
authors: Chen
mesh_terms: D000328:Adult; D001281:Atrial Fibrillation / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology / Q000401:mortality / Q000473:pathology / Q000503:physiopathology; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013923:Thromboembolism / Q000209:etiology / Q000401:mortality / Q000473:pathology / Q000503:physiopathology