TY - JOUR
T1 - Risk of Ischemic Stroke in Patients with End-Stage Renal Disease Receiving Peritoneal Dialysis with New-Onset Atrial Fibrillation
AU - Lee, Yin-Hao
AU - Chen, Yung-Tai
AU - Chang, Chun-Chin
AU - Hsu, Chien-Yi
AU - Su, Yu-Wen
AU - Li, Szu-Yuan
AU - Huang, Chin-Chou
AU - Leu, Hsin-Bang
AU - Huang, Po-Hsun
AU - Chen, Jaw-Wen
AU - Lin, Shing-Jong
N1 - Publisher Copyright:
© 2020 Lippincott Williams and Wilkins. All rights reserved.
PY - 2020
Y1 - 2020
N2 - 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 CHA
2DS
2-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 CHA
2DS
2-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 CHA
2DS
2-VASc score remained associated with the risk of ischemic stroke in patients undergoing PD with AF.
AB - 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 CHA
2DS
2-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 CHA
2DS
2-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 CHA
2DS
2-VASc score remained associated with the risk of ischemic stroke in patients undergoing PD with AF.
KW - Atrial fibrillation
KW - Peritoneal dialysis
KW - Stroke
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U2 - 10.1097/JCMA.0000000000000417
DO - 10.1097/JCMA.0000000000000417
M3 - Article
C2 - 32858549
SN - 1726-4901
VL - 83
SP - 1066
EP - 1070
JO - Journal of the Chinese Medical Association : JCMA
JF - Journal of the Chinese Medical Association : JCMA
IS - 12
ER -