Document Detail


Influence of atrial fibrillation on the morbido-mortality of patients on hemodialysis.
MedLine Citation:
PMID:  11099992     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The consequences of atrial fibrillation (AF) on morbido-mortality of patients on hemodialysis have not been fully explored. The objective of this study was to determine the prevalence of AF in patients on hemodialysis and to evaluate its influence on the development of thromboembolic phenomena (TEP). METHODS: The incidence of AF in 190 patients in our hemodialysis program was assessed, and the patients were followed up for 1 year. Pertinent demographic and biochemical parameters were entered into univariate and multivariate statistical analyses to evaluate associations with overall mortality and TEP such as cerebrovascular accident, transitory ischemic accident, or peripheral embolism. RESULTS: In 13.6% of patients, AF was found; 9.4% of these were of the permanent type. In the multivariate analysis, only increased age was associated with a higher probability of having arrhythmia (odds ratio, 1.10; 95% confidence interval, 1.03-1.17; P =.003). During follow-up, 23% of the patients with AF died compared with 6% of those in sinus rhythm (P <.05), although AF did not appear to be an independent predictive factor for death. Thirty-five percent of the patients with AF and 4% with sinus rhythm had TEP (P <.01). In the multivariate analysis, AF was identified as the only independent predictor for TEP (odds ratio, 8; 95% CI, 2.3-27; P =.0008). CONCLUSIONS: AF is a frequent arrhythmia in patients on hemodialysis, and approximately 1 in 3 hemodialysis patients with AF had thromboembolic complications within 1 year of follow-up. These findings suggest that the consensus contraindication of prophylactic anticoagulation therapy for this group of patients may need to be redefined.
Authors:
E Vázquez; C Sánchez-Perales; F Borrego; M J Garcia-Cortés; C Lozano; M Guzmán; J M Gil; M J Borrego; V Pérez
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  140     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  2000 Dec 
Date Detail:
Created Date:  2000-12-20     Completed Date:  2001-01-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  886-90     Citation Subset:  AIM; IM    
Affiliation:
Unidad de Cardiología and Servicio de Nefrología, Hospital General de Especialidades, Ciudad de Jaén, Spain. vazquez89@arrakis.es
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Anticoagulants / therapeutic use
Atrial Fibrillation / complications,  epidemiology*,  prevention & control
Brain Ischemia / etiology,  mortality*,  prevention & control
Cross-Sectional Studies
Female
Humans
Incidence
Kidney Failure, Chronic / therapy
Male
Middle Aged
Prevalence
Prognosis
Recurrence
Renal Dialysis / adverse effects,  mortality*
Risk Factors
Survival Rate
Thromboembolism / etiology,  mortality*,  prevention & control
Chemical
Reg. No./Substance:
0/Anticoagulants

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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