Atrial fibrillation and chronic kidney disease: main clinical characteristics of patients in selected subjects of the Russian Federation

Aim. To compare clinical characteristics of patients with atrial fibrillation (AF) depending on renal filtration function based on a retrospective analysis of data in individual subjects of the Russian Federation (RF).Material and methods. The information was taken from the Webiomed predictive analy...

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Main Authors: M. A. Druzhilov, T. Yu. Kuznetsova, O. Yu. Druzhilova, U. D. Arustamova, D. V. Gavrilov, A. V. Gusev
Format: Article
Language:Russian
Published: «SILICEA-POLIGRAF» LLC 2023-05-01
Series:Кардиоваскулярная терапия и профилактика
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Online Access:https://cardiovascular.elpub.ru/jour/article/view/3544
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author M. A. Druzhilov
T. Yu. Kuznetsova
O. Yu. Druzhilova
U. D. Arustamova
D. V. Gavrilov
A. V. Gusev
author_facet M. A. Druzhilov
T. Yu. Kuznetsova
O. Yu. Druzhilova
U. D. Arustamova
D. V. Gavrilov
A. V. Gusev
author_sort M. A. Druzhilov
collection DOAJ
description Aim. To compare clinical characteristics of patients with atrial fibrillation (AF) depending on renal filtration function based on a retrospective analysis of data in individual subjects of the Russian Federation (RF).Material and methods. The information was taken from the Webiomed predictive analytics platform, including 80775 patients with AF (men, 42,5%, mean age, 70,0±14,3 years) who underwent outpatient and/or inpatient treatment in medical organizations in 6 Russian subjects in 2016-2019 with data on blood creatinine levels. For comparative analysis, the ranges of estimated glomerular filtration rate (eGFR) were selected: ≥60 ml/min/1,73 m2, 30–59 ml/min/1,73 m2, and <30 ml/min/1,73 m2.Results. The analysis showed that 45128 (55,9%) patients were characterized by eGFR <60 ml/min/1,73 m2, of which in 35212 (78%) patients eGFR was in the range of 30-59 ml/min/1,73 m2, in 9916 (22%) — <30 ml/min/1,73 m2. Patients with eGFR <60 ml/min/1,73 m2 compared with those with eGFR ≥60 ml/min/1,73 m2 were older (75,4±10,9 vs 63,0±15,2 years, p<0,001), had higher incidence of ischemic stroke (IS) (10,9 vs 6,5%, p<0,001), myocardial infarction (MI) (11,5 vs 7,7%, p<0,001) and intracranial hemorrhage (ICH) (1,0 vs 0,7%, p<0,01), as well as higher rate of anticoagulant therapy (ACT) (47,0 vs 33,2%, p<0,001). Men and women with eGFR of 30-59 and <30 ml/min/1,73 m2 in the age ranges ≤64 years and 65-74 years had a higher incidence of IS and MI compared with patients with eGFR ≥60 ml/min/173 m2. The frequency of ICH on warfarin compared with direct oral anticoagulants was significantly higher in the subgroup with eGFR of 30-59 ml/min/1,73 m2 (1,1 vs 0,7%, p<0,01).Conclusion. Patients with AF and eGFR <60 ml/min/1,73 m2 are charac­terized by greater comorbidity, a higher incidence of IS, MI and ICH compared with patients with AF and eGFR ≥60 ml/min/1,73 m2, while ACT prescription rate as of 2016-2019 in some Russian subjects was unsatisfactory. This emphasizes the need to optimize risk stratification, ACT and algorithms for the prevention of athero­thrombotic events, as well as the development of nephro­protective strategies to reduce the rate of progression of renal dys­function in this cohort of patients.
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spelling doaj-art-9e489e0b24f34d7aa67cd018d0e855112025-08-20T03:35:51Zrus«SILICEA-POLIGRAF» LLCКардиоваскулярная терапия и профилактика1728-88002619-01252023-05-0122410.15829/1728-8800-2023-35442690Atrial fibrillation and chronic kidney disease: main clinical characteristics of patients in selected subjects of the Russian FederationM. A. Druzhilov0T. Yu. Kuznetsova1O. Yu. Druzhilova2U. D. Arustamova3D. V. Gavrilov4A. V. Gusev5Petrozavodsk State UniversityPetrozavodsk State UniversityPetrozavodsk State UniversityPetrozavodsk State UniversityOOO K-SkyCentral Research Institute for Health Organization and InformatizationAim. To compare clinical characteristics of patients with atrial fibrillation (AF) depending on renal filtration function based on a retrospective analysis of data in individual subjects of the Russian Federation (RF).Material and methods. The information was taken from the Webiomed predictive analytics platform, including 80775 patients with AF (men, 42,5%, mean age, 70,0±14,3 years) who underwent outpatient and/or inpatient treatment in medical organizations in 6 Russian subjects in 2016-2019 with data on blood creatinine levels. For comparative analysis, the ranges of estimated glomerular filtration rate (eGFR) were selected: ≥60 ml/min/1,73 m2, 30–59 ml/min/1,73 m2, and <30 ml/min/1,73 m2.Results. The analysis showed that 45128 (55,9%) patients were characterized by eGFR <60 ml/min/1,73 m2, of which in 35212 (78%) patients eGFR was in the range of 30-59 ml/min/1,73 m2, in 9916 (22%) — <30 ml/min/1,73 m2. Patients with eGFR <60 ml/min/1,73 m2 compared with those with eGFR ≥60 ml/min/1,73 m2 were older (75,4±10,9 vs 63,0±15,2 years, p<0,001), had higher incidence of ischemic stroke (IS) (10,9 vs 6,5%, p<0,001), myocardial infarction (MI) (11,5 vs 7,7%, p<0,001) and intracranial hemorrhage (ICH) (1,0 vs 0,7%, p<0,01), as well as higher rate of anticoagulant therapy (ACT) (47,0 vs 33,2%, p<0,001). Men and women with eGFR of 30-59 and <30 ml/min/1,73 m2 in the age ranges ≤64 years and 65-74 years had a higher incidence of IS and MI compared with patients with eGFR ≥60 ml/min/173 m2. The frequency of ICH on warfarin compared with direct oral anticoagulants was significantly higher in the subgroup with eGFR of 30-59 ml/min/1,73 m2 (1,1 vs 0,7%, p<0,01).Conclusion. Patients with AF and eGFR <60 ml/min/1,73 m2 are charac­terized by greater comorbidity, a higher incidence of IS, MI and ICH compared with patients with AF and eGFR ≥60 ml/min/1,73 m2, while ACT prescription rate as of 2016-2019 in some Russian subjects was unsatisfactory. This emphasizes the need to optimize risk stratification, ACT and algorithms for the prevention of athero­thrombotic events, as well as the development of nephro­protective strategies to reduce the rate of progression of renal dys­function in this cohort of patients.https://cardiovascular.elpub.ru/jour/article/view/3544atrial fibrillationchronic kidney diseaseischemic strokemyocardial infarctionanticoagulant therapy
spellingShingle M. A. Druzhilov
T. Yu. Kuznetsova
O. Yu. Druzhilova
U. D. Arustamova
D. V. Gavrilov
A. V. Gusev
Atrial fibrillation and chronic kidney disease: main clinical characteristics of patients in selected subjects of the Russian Federation
Кардиоваскулярная терапия и профилактика
atrial fibrillation
chronic kidney disease
ischemic stroke
myocardial infarction
anticoagulant therapy
title Atrial fibrillation and chronic kidney disease: main clinical characteristics of patients in selected subjects of the Russian Federation
title_full Atrial fibrillation and chronic kidney disease: main clinical characteristics of patients in selected subjects of the Russian Federation
title_fullStr Atrial fibrillation and chronic kidney disease: main clinical characteristics of patients in selected subjects of the Russian Federation
title_full_unstemmed Atrial fibrillation and chronic kidney disease: main clinical characteristics of patients in selected subjects of the Russian Federation
title_short Atrial fibrillation and chronic kidney disease: main clinical characteristics of patients in selected subjects of the Russian Federation
title_sort atrial fibrillation and chronic kidney disease main clinical characteristics of patients in selected subjects of the russian federation
topic atrial fibrillation
chronic kidney disease
ischemic stroke
myocardial infarction
anticoagulant therapy
url https://cardiovascular.elpub.ru/jour/article/view/3544
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