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Risk of ischemic stroke in patients with end-stage renal disease receiving peritoneal dialysis with new-onset atrial fibrillation
- Source :
- Journal of the Chinese Medical Association : JCMA. 83(12)
- Publication Year :
- 2020
-
Abstract
- Background The clinical effect of atrial fibrillation (AF)-related ischemic cardiovascular events in patients undergoing peritoneal dialysis (PD) remains uncertain. This study aimed to investigate the risk of ischemic events in patients undergoing PD with new-onset AF compared with that in patients without AF and ascertain the association between the CHA2DS2-VASc score and risk of ischemic stroke. Methods This nationwide, population-based cohort study used data from Taiwan's National Health Insurance Research Database from 1998 to 2011 for patients receiving PD with or without new-onset AF. The clinical endpoints included ischemic stroke, all-cause death, and in-hospital cardiovascular death. Results Patients undergoing PD with new-onset AF (N = 505) had significantly higher risks of ischemic stroke (adjusted hazard ratio [aHR], 1.98; 95% CI, 1.40-2.80), all-cause death (aHR, 1.61; 95% CI, 1.40-1.85), and in-hospital cardiovascular death (aHR, 1.82; 95% CI, 1.50.2.21) compared with those in patients undergoing PD without AF. After considering in-hospital death as a competing risk, AF remained associated with an increased risk of ischemic stroke (hazard ratio [HR], 1.67; 95% CI, 1.17-2.37). The CHA2DS2-VASc score was associated with the risk of ischemic stroke (HR, 1.28; 95% CI, 1.12-1.46). Conclusion The risks of ischemic stroke, all-cause death, and in-hospital cardiovascular death were significantly higher in patients undergoing PD with AF than those in patients without AF. The CHA2DS2-VASc score remained associated with the risk of ischemic stroke in patients undergoing PD with AF.
- Subjects :
- Adult
Male
medicine.medical_specialty
medicine.medical_treatment
Population
Taiwan
030204 cardiovascular system & hematology
Peritoneal dialysis
End stage renal disease
03 medical and health sciences
0302 clinical medicine
Risk Factors
Internal medicine
Atrial Fibrillation
medicine
Clinical endpoint
Humans
education
Stroke
Aged
Ischemic Stroke
education.field_of_study
business.industry
Hazard ratio
Atrial fibrillation
General Medicine
Middle Aged
medicine.disease
030220 oncology & carcinogenesis
Cardiology
Kidney Failure, Chronic
Female
business
Peritoneal Dialysis
Cohort study
Subjects
Details
- ISSN :
- 17287731
- Volume :
- 83
- Issue :
- 12
- Database :
- OpenAIRE
- Journal :
- Journal of the Chinese Medical Association : JCMA
- Accession number :
- edsair.doi.dedup.....80d1c32bc8049575cdddd3d49960875d