title: New-onset Atrial Fibrillation is Associated With Polycystic Kidney Disease: A Nationwide Population-based Cohort Study.
abstract: Cardiovascular complications remain the major problems contributing to morbidity and mortality in patients with polycystic kidney disease (PKD). Therefore, the authors hypothesized that atrial fibrillation (AF) is closely associated with PKD. The authors conducted a nationwide population-based cohort study to investigate the risk of AF in patients with PKD. Using data from inpatient claims, the authors enrolled 7203 patients aged over 20 years who were diagnosed with PKD from 1998 to 2010 with no history of AF as the PKD cohort. They randomly selected 28,739 people without PKD as controls and frequency matched them with patients with PKD according to their age, sex, and baseline comorbidity. In total, 247 PKD patients were diagnosed with AF, representing an incidence of 7.08 per 1000 person-years, whereas 807 cases of AF occurred in the comparison cohort, yielding an incidence of 4.98 per 1000 person-y, with an adjusted HR (aHR) of 1.31 (95% CI = 1.14-1.51). The risk of AF increased from an aHR of 1.59 (95% CI = 1.15-2.21) to 3.64 (95% CI = 1.93-6.85) when the number of risk factors increased from 1 to more than 5 in comparison with patients without risk factors. A remarkably high incidence rate and risk was observed in patients with PKD when multiple risk factors were combined. A high index of suspicion should be maintained when examining PKD patients with irregular betas. Early prophylactic therapy is warranted in these patients.
authors.affiliation: From the Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University (T-MY, C-HK); Division of Nephrology, Taichung Veterans General Hospital, Taichung (T-MY, Y-WC); Department of Pediatric Nephrology, Chang Gung Children's Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan (M-CY); Management Office for Health Data, China Medical University Hospital, Taichung (C-LL); Neurology and Medical Intensive Care Unit, Changhua Christian Hospital, Changhua (C-CC); College of Medicine, China Medical University (C-LL); and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan (C-HK).
authors.forename: Tung-Min
authors.initials: TM
authors.lastname: Yu
authors.forename: Ya-Wen
authors.initials: YW
authors.lastname: Chuang
authors.forename: Mei-Ching
authors.initials: MC
authors.lastname: Yu
authors.forename: Shih-Ting
authors.initials: ST
authors.lastname: Huang
authors.forename: Che-Yi
authors.initials: CY
authors.lastname: Chou
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
authors.forename: Chun-Ching
authors.initials: CC
authors.lastname: Chiu
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology*; D016022:Case-Control Studies; D015897:Comorbidity; D005260:Female; D006333:Heart Failure / Q000453:epidemiology*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D007690:Polycystic Kidney Diseases / Q000453:epidemiology*; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
references.citation: J Am Soc Nephrol. 2009 Sep;20(9):1888-93
references.pmid: 19696226
references.citation: Am J Nephrol. 2012;36(4):362-70
references.pmid: 23038404
references.citation: Circulation. 2012 May 1;125(17):2059-70
references.pmid: 22456474
references.citation: Proc Natl Acad Sci U S A. 2007 Apr 10;104(15):6454-9
references.pmid: 17404231
references.citation: N Engl J Med. 1988 Oct 6;319(14):907-12
references.pmid: 3419455
references.citation: J Clin Invest. 2011 Aug;121(8):2955-68
references.pmid: 21804195
references.citation: Am J Physiol Heart Circ Physiol. 2005 Sep;289(3):H1002-12
references.pmid: 15849234
references.citation: Nat Cell Biol. 2002 Mar;4(3):191-7
references.pmid: 11854751
references.citation: Circulation. 2010 Jun 22;121(24):2615-23
references.pmid: 20529998
references.citation: Kidney Int. 2015 Jun;87(6):1209-15
references.pmid: 25587708
references.citation: Lancet. 2007 Apr 14;369(9569):1287-1301
references.pmid: 17434405
references.citation: Proc Natl Acad Sci U S A. 2014 Nov 18;111(46):16604-9
references.pmid: 25368166
references.citation: Am J Kidney Dis. 2001 Dec;38(6):1208-16
references.pmid: 11728952
references.citation: Am J Kidney Dis. 1998 Dec;32(6):970-5
references.pmid: 9856512
references.citation: Circ Arrhythm Electrophysiol. 2008 Apr;1(1):62-73
references.pmid: 19808395
references.citation: Am J Nephrol. 2000 May-Jun;20(3):193-200
references.pmid: 10878400
references.citation: Annu Rev Physiol. 2008;70:23-49
references.pmid: 17988210
references.citation: Am J Nephrol. 1998;18(5):391-8
references.pmid: 9730562
references.citation: J Mol Cell Cardiol. 2013 May;58:199-208
references.pmid: 23376035
references.citation: Kidney Int. 2005 Nov;68(5):2244-9
references.pmid: 16221225
references.citation: J Am Soc Nephrol. 1997 Aug;8(8):1292-7
references.pmid: 9259356
references.citation: Eur Heart J. 2006 Apr;27(8):949-53
references.pmid: 16527828
references.citation: J Am Coll Cardiol. 2014 Jun 10;63(22):2335-45
references.pmid: 24613319
references.citation: Nat Rev Nephrol. 2015 Aug;11(8):451-64
references.pmid: 25870007
references.citation: Nat Rev Cardiol. 2012 Oct;9(10):561-75
references.pmid: 22733215
references.citation: Biomedicine (Taipei). 2015 Jun;5(2):7
references.pmid: 26048694
references.citation: Circulation. 2011 Jan 18;123(2):137-46
references.pmid: 21200008