ISSN 2149-2263 | E-ISSN 2149-2271
Volume : 25 Issue : 9 Year : 2021
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The Anatolian Journal of Cardiology Impact of kidney function on the occurrence of new-onset atrial fibrillation in patients with ST-elevation myocardial infarction [Anatol J Cardiol]
Anatol J Cardiol. 2021; 25(9): 638-645 | DOI: 10.5152/AnatolJCardiol.2021.35332

Impact of kidney function on the occurrence of new-onset atrial fibrillation in patients with ST-elevation myocardial infarction

Lidija Savic1, Igor Mrdovic1, Milika Asanin1, Sanja Stankovic2, Gordana Krljanac1, Ratko Lasica1, Mihajlo Viduljevic1
1University Clinical Center of Serbia, Emergency Hospital, Coronary Care Unit and Cardiology Clinic, Belgrade, Serbia
2Center for Medical Biochemistry, Emergency Hospital, University Clinical Center of Serbia, Belgrade, Serbia

Objective: In this study, we aimed to examine the prognostic impact of decreased kidney function at admission on the occurrence of new-onset atrial fibrillation (AF) in patients with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI).
Methods: The study enrolled 3,115 consecutive patients with STEMI. Kidney function was assessed by estimation of the glomerular filtration rate (eGFR) at admission. Patients with cardiogenic shock at admission, patients on hemodialysis, and patients with a medical history of previous AF (paroxysmal, persistent, or permanent) were excluded. The follow-up period was six years.
Results: New-onset AF occurred in 215 (6.9%) patients, 75 (34.9%) patients presented with AF, and 140 (65.1%) patients developed AF after pPCI. The median time of AF occurrence in patients who did not present with AF was 4.5 (interquartile range 1–25) hours after pPCI. New-onset AF was associated with a higher short- and long-term mortality. In the multiple logistic regression analysis, all stages of reduced kidney function were independent predictors for the occurrence of new-onset AF, and negative prognostic impact increased with the deterioration of kidney function: eGFR <90 mL/min/m2, hazard ratio (HR) 1.96, 95% confidence interval (CI) 1.42-2.89, p=0.011; eGFR 60-89 mL/min/m2, HR 1.54, 95% CI 1.13-2.57, p=0.045; eGFR 45-59 mL/min/m2-, HR 2.09, 95% CI 1.24-2.85, p=0.023; eGFR 30-44 mL/min/m2-, HR 2.93, 95% CI 1.64-5.29, p<0.001; eGFR 15-29 mL/min/m2-, HR 5.51, 95% CI 2.67-11.39, p<0.001.
Conclusion: Decreased kidney function was significantly associated with the occurrence of new-onset AF, and its impact increased with the deterioration in kidney function, starting with an eGFR value of 90 mL/min/m2. New-onset AF was an independent predictor of long-term all-cause mortality in the analyzed patients.

Keywords: New-onset atrial fibrillation, kidney function, myocardial infarction

Lidija Savic, Igor Mrdovic, Milika Asanin, Sanja Stankovic, Gordana Krljanac, Ratko Lasica, Mihajlo Viduljevic. Impact of kidney function on the occurrence of new-onset atrial fibrillation in patients with ST-elevation myocardial infarction. Anatol J Cardiol. 2021; 25(9): 638-645

Corresponding Author: Lidija Savic, Serbia