Renal Dysfunction Predicts Major Adverse Cardiovascular Events in Black
and Latino Patients Who Have Atrial Fibrillation
Abstract
Background: Atrial Fibrillation (AF) is present in over 6 million
Americans. However, AF occurs less commonly in African Americans and
Latinos compared to Caucasians. Major adverse cardiovascular events
(MACE) is the leading cause of death in these populations. Hypothesis:
We theorize that glomerular filtration rates (GFR) is an independent
risk factor for MACE in African Americans and Latinos with non-valvular
AF (NVAF). Methods: The association of reduced GFR with MACE in NVAF
patients was investigated by retrospective chart review. 656 patients
were included: 339 with GFR <60 and 317 with GFR ≥60. A
Chi-square test, two-sample t-test, or Wilcoxon Rank Sum test was used
to test for differences between the two groups in terms of demographic
variables and other risk factors. The association between GFR groups and
myocardial infarction (MI), stroke, and/or death, was tested using
binomial logistic regression. To incorporate the element of time and
adjust for covariates, a Cox proportional hazards model analysis was
applied for each outcome variable. Results: As compared to GFR ≥60, a
GFR <60 in NVAF was an independent risk factor for MI (HR 1.88
(1.17, 3.04); p=0.009); death (HR 1.63 (1.11, 2.41); p=0.014) and MI,
stroke or death ((HR 1.37 (1.05, 1.78); p=0.018). GFR <60 was
not an independent risk factor for stroke (HR 1.13 (0.77, 1.65);
p=0.529) Conclusion: Renal dysfunction in patients with NVAF is an
independent risk factor for MI, death in and composite of MI, stroke and
death in African American and Latino populations.