The relationship between renal dysfunction and stroke risk in patients with non-valvular atrial fibrillation

Objective To explore the relationship between renal dysfunction and stroke risk evaluated by estimated glomerular filtration rate(eGFR)and CHA2DS2-VASc score in patients with non-valvular atrial fibrillation(NVAF). Methods From January 2012 to December 2016, NVAF patients at the First Affiliated Hospital of Nanjing Medical University were identified using digital medical record retrieve system.eGFR and CHA2DS2-VASc score were calculated for each participant.Patients were stratified according to different levels of eGFR.Clinical characteristics were compared and described between groups.Correlation analysis was used to reveal the possible relationship between CHA2DS2-VASc score and eGFR.Multiple linear regression analysis was used to evaluate which item of the CHA2DS2-VASc score correlated with eGFR the most. Results A total of 2 298 patients were included in the study.The correlation analysis showed a negative correlation between eGFR and CHA2DS2-VASc score(Pearson’s coefficient -0.357, P<0.001). The multiple linear regression analysis demonstrated that congestive heart failure(unstandardized β -11.440, P<0.001), hypertension(unstandardized β -6.504, P<0.001), age≥65 years(unstandardized β -8.666, P<0.001), prior history of transient ischemic attack or thromboembolism(unstandardized β -4.411, P<0.001)and female(unstandardized β -2.092, P=0.021)were most related to decreased eGFR among all the factors of CHA2DS2-VASc score.Diabetes and vascular diseases had no significant relationship with renal dysfunction. Conclusion eGFR has a negative correlation with CHA2DS2-VASc scores. Key words: Atrial fibrillation; Impaired renal function; Stroke