目的:基于胱抑素C和基于肌酐的估计肾小球滤过率(eGFRdiff)之间的差异被认为反映了与心血管风险相关的不同于肾功能的因素。然而,eGFRdiff与心房颤动(AF)风险之间的关联尚未得到广泛评估.
方法:前瞻性队列研究。
方法:使用英国生物银行的数据,这项研究纳入了363,494名参与者,他们测定了血清肌酐和胱抑素C水平,且没有房颤的既往诊断或相关手术史.
方法:eGFRdiff,计算为基于胱抑素C的eGFR减去基于肌酐的eGFR。eGFRdiff也被归类为阴性(<-15mL/min/1.73m2),中档(-15至15毫升/分钟/1.73。m2),或呈阳性(≥15mL/min/1.73。m2)。
结果:事故AF。
方法:适合子分布风险模型,将房颤发展前发生的死亡视为竞争事件。
结果:在11.7年的中位随访期间,18,994名(5.2%)参与者发生房颤事件。在多变量调整模型中,eGFRdiff为阴性的参与者发生房颤的风险较高(子分布风险比[sHRs],1.25;95%置信区间[CI],1.20-1.30),而eGFRdiff阳性的参与者患房颤的风险较低(sHR,0.81;95%CI,0.77-0.87),与那些具有中档eGFRdiff的人相比。当eGFRdiff在调整后的模型中被视为连续变量时,eGFRdiff每升高10mL/min/1.73m2,发生房颤的风险降低0.90倍.
结论:基线血清肌酐和胱抑素C水平的单一测量。
结论:基于胱抑素C和基于肌酐的eGFR之间的差异与房颤发生的风险相关。较高的eGFRdiff与较低的AF风险相关。这些发现可能对有房颤风险的患者的管理产生影响。
The difference between cystatin C-based and creatinine-based estimated glomerular filtration rate (eGFRdiff) has been suggested to reflect factors distinct from kidney function that are associated with cardiovascular risk. However, the association between eGFRdiff and atrial fibrillation (AF) risk has not been extensively evaluated.
Prospective cohort
study.
Using data from the UK Biobank, this
study included 363,494 participants with measured serum creatinine and cystatin C levels and without a prior diagnosis of AF or a history of related procedures.
Estimated GFRdiff, calculated as cystatin C-based eGFR minus creatinine-based eGFR. Estimated GFRdiff was also categorized as negative (<-15mL/min/1.73m2), midrange (-15 to 15mL/min/1.73m2), or positive (≥15mL/min/1.73m2).
Incident AF.
Subdistribution hazard models were fit, treating death that occurred before development of AF as a competing event.
During the median follow-up period of 11.7 years, incident AF occurred in 18,994 (5.2%) participants. In the multivariable-adjusted model, participants with a negative eGFRdiff had a higher risk of incident AF (subdistribution HR [SHR], 1.25 [95% CI, 1.20-1.30]), whereas participants with a positive eGFRdiff had a lower risk of AF (SHR, 0.81 [95% CI, 0.77-0.87]) compared with those with a midrange eGFRdiff. When eGFRdiff was treated as a continuous variable in the adjusted model, every 10mL/min/1.73m2 higher eGFRdiff was associated with a 0.90-fold decrease in the risk of incident AF.
A single measurement of baseline serum creatinine and cystatin C levels.
The difference between cystatin C- and creatinine-based eGFRs was associated with the risk of AF development. A higher eGFRdiff was associated with a lower risk of AF. These findings may have implications for the management of patients at risk of incident AF.
The difference between cystatin C-based estimated glomerular filtration rate (eGFR) and creatinine-based eGFR has recently gained attention as a potential indicator of cardiovascular outcomes influenced by factors other than kidney function. This
study investigated the association between the differences in 2 eGFRs (cystatin C-based eGFR minus creatinine-based eGFR) and incident atrial fibrillation (AF) among>340,000 participants from the UK Biobank
Study. Compared with those with a near zero eGFR difference, participants with a negative eGFR difference had a higher risk of AF, while those with a positive eGFR difference had a lower risk. These findings suggest that measuring eGFR differences may help identify individuals at a higher risk of developing AF.