Yıl: 2020 Cilt: 29 Sayı: 3 Sayfa Aralığı: 215 - 220 Metin Dili: İngilizce DOI: 10.5152/turkjnephrol.2020.4130 İndeks Tarihi: 15-06-2021

Prevalence and Characteristics of Atrial Fibrillation inTurkish Patients Undergoing Hemodialysis

Öz:
Objective: Atrial fibrillation (AF) is one of the most common and cumulatively important cardiac arrhythmias. Prevalence of AF is much higher in patients with chronic kidney disease (may be up to 27%). We aimed to study the prevalence and clinical features of AF in hemodialysis centers.Materials and Methods: Patients who had been under chronic in-center hemodialysis for at least 6 months and were ≥18 years of age were included in this cross-sectional study conducted at five hemodialysis centers across İstanbul between May 2017 and July 2017. Medical history, clinical (including medications and echocardiography), and laboratory data were obtained using a standardized study form. Results: The data of 632 prevalent patients undergoing in-center hemodialysis (mean age 62.7±13.9 years, males 350 and females 282) were included in the analysis. AF was present in 92 (14.5%) of the patients. The prevalence of AF was lowest in patients <55 years of age and showed an increasing trend with age. While age, coronary artery disease, heart failure, and cerebrovascular events were associated with the presence of AF; left ventricular hypertrophy, diabetes and hypertension were not. Overall, 78% of patients with AF were using either single or a combination of antithrombotic agents. Less than 10% of AF patients were receiving warfarin. The rates of antiplatelet agents and warfarin use were not different between patients with a CHA2DS2-VASc score of ≥2 or less.Conclusion: AF is highly prevalent in patients undergoing hemodialysis, and warfarin was used in nearly 5% of the patients with AF undergoing hemodialysis in this study, which suggests that the current knowledge is unconvincing to proceed for the treatment with anticoagulation. Further studies are needed to guide the management for prevention of strokes in patients with AF undergoing dialysis.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Chugh SS, Havmoeller R, Narayanan K, Singh D, Rienstra M, Benjamin EJ, et al. Worldwide epidemiology of atrial fibrillation: A Global Burden of Disease 2010 Study. Circulation 2014; 129: 837-47. [Crossref]
  • 2. Korantzopoulos P, Kokkoris S, Liu T, Protopsaltis I, Li G, Goudevenos JA. Atrial fibrillation in end-stage renal disease. Pacing Clin Electrophysiol 2007; 30: 1391-7. [Crossref]
  • 3. Voroneanu L, Ortiz A, Nistor I, Covic A. Atrial fibrillation in chronic kidney disease. Eur J Intern Med 2016; 33: 3-13. [Crossref]
  • 4. Lau YC, Proietti M, Guiducci E, Blann AD, Lip GYH. Atrial fibrillation and thromboembolism in patients with chronic kidney disease. J Am Coll Cardiol 2016; 68: 1452-64. [Crossref]
  • 5. Wetmore JB, Ellerbeck EF, Mahnken JD, Phadnis M, Rigler SK, Mukhopadhyay P, et al. Atrial fibrillation and risk of stroke in dialysis patients. Ann Epidemiol 2013; 23: 112-8. [Crossref]
  • 6. Herzog CA, Asinger RW, Berger AK, Charytan DM, Díez J, Hart RG, et al. Cardiovascular disease in chronic kidney disease. A clinical update from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int 2011; 80: 572-86. [Crossref]
  • 7. January CT, Wann LS, Alpert JS, Calkins H, Cigarroa JE, Cleveland Jr JC, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol 2014; 64: e1-76.
  • 8. Lip GY, Nieuwlaat R, Pisters R, Lane DA, Crijns HJ. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: The euro heart survey on atrial fibrillation. Chest 2010; 137: 263-72. [Crossref]
  • 9. Bansal VK, Herzog CA, Sarnak MJ, Choi MJ, Mehta R, Jaar BG, et al. Oral anticoagulants to prevent stroke in nonvalvular atrial fibrillation in patients with CKD stage 5D: An NKF-KDOQI Controversies Report. Am J Kidney Dis 2017; 70: 859-68. [Crossref]
  • 10. Go AS, Hylek EM, Phillips KA, Chang Y, Henault LE, Selby JV, et al. Prevalence of diagnosed atrial fibrillation in adults: National implications for rhythm management and stroke prevention: The AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA 2001; 285: 2370-5. [Crossref]
  • 11. Svennberg E, Engdahl J, Al-Khalili F, Friberg L, Frykman V, Rosenqvist M. Mass screening for untreated atrial fibrillation: The STROKESTOP Study. Circulation 2015; 131: 2176-84. [Crossref]
  • 12. Süleymanlar G, Ates K, Seyahi N. Registry of the nephrology, dialysis and transplantation in Turkey: Registry 2015. Ministry of Health and Turkish Society of Nephrology Joint Report; 2016.
  • 13. Atar I, Konas D, Acikel S, Külah E, Atar A, Bozbaş H, et al. Frequency of atrial fibrillation and factors related to its development in dialysis patients. Int J Cardiol 2006; 106: 47-51. [Crossref]
  • 14. Wizemann V, Tong L, Satayathum S, Disney A, Akiba T, Fissell RB, et al. Atrial fibrillation in hemodialysis patients: Clinical features and associations with anticoagulant therapy. Kidney Int 2010; 77: 1098-106. [Crossref]
  • 15. Genovesi S, Pogliani D, Faini A, Valsecchi MG, Riva A, Stefani F, et al. Prevalence of atrial fibrillation and associated factors in a population of long-term hemodialysis patients. Am J Kidney Dis 2005; 46: 897-902. [Crossref]
  • 16. Olesen JB, Lip GY, Kamper AL, Hommel K, Køber L, Lane DA, et al. Stroke and bleeding in atrial fibrillation with chronic kidney disease. N Engl J Med 2012; 367: 625-35. [Crossref]
  • 17. Zimmerman D, Sood MM, Rigatto C, Holden RM, Hiremath S, Clase CM. Systematic review and meta-analysis of incidence, prevalence and outcomes of atrial fibrillation in patients on dialysis. Nephrol Dial Transplant 2012; 27: 3816-22. [Crossref]
  • 18. Shah M, Avgil Tsadok M, Jackevicius CA, Essebag V, Eisenberg MJ, Rahme E, et al. Warfarin use and the risk for stroke and bleeding in patients with atrial fibrillation undergoing dialysis. Circulation 2014; 129: 1196-203. [Crossref]
  • 19. Nochaiwong S, Ruengorn C, Awiphan R, Dandecha P, Noppakun K, Phrommintikul A. Efficacy and safety of warfarin in dialysis patients with atrial fibrillation: A systematic review and meta-analysis. Open Heart 2016; 3: e000441. [Crossref]
  • 20. Chan KE, Lazarus JM, Thadhani R, Hakim RM. Warfarin use associates with increased risk for stroke in hemodialysis patients with atrial fibrillation. J Am Soc Nephrol 2009; 20: 2223-33. [Crossref]
  • 21. Bonde AN, Lip GY, Kamper AL, Hansen PR, Lamberts M, Hommel K, et al. Net clinical benefit of antithrombotic therapy in patients with atrial fibrillation and chronic kidney disease: A nationwide observational cohort study. J Am Coll Cardiol 2014; 64: 2471-82. [Crossref]
  • 22. Herrington W, Haynes R, Staplin N, Emberson J, Baigent C, Landray M. Evidence for the prevention and treatment of stroke in dialysis patients. Semin Dial 2015; 28: 35-47. [Crossref]
  • 23. Bassand JP. Review of atrial fibrillation outcome trials of oral anticoagulant and antiplatelet agents. Europace 2012; 14: 312-24. [Crossref]
APA Hasbal N, koc y, sakaci t, Sevinc M, atan uçar z, Sahutoglu T, Akgol C, Ahbap E, unsal a, basturk t (2020). Prevalence and Characteristics of Atrial Fibrillation inTurkish Patients Undergoing Hemodialysis. , 215 - 220. 10.5152/turkjnephrol.2020.4130
Chicago Hasbal Nuri Baris,koc yener,sakaci tamer,Sevinc Mustafa,atan uçar zuhal,Sahutoglu Tuncay,Akgol Cuneyt,Ahbap Elbis,unsal abdulkadir,basturk taner Prevalence and Characteristics of Atrial Fibrillation inTurkish Patients Undergoing Hemodialysis. (2020): 215 - 220. 10.5152/turkjnephrol.2020.4130
MLA Hasbal Nuri Baris,koc yener,sakaci tamer,Sevinc Mustafa,atan uçar zuhal,Sahutoglu Tuncay,Akgol Cuneyt,Ahbap Elbis,unsal abdulkadir,basturk taner Prevalence and Characteristics of Atrial Fibrillation inTurkish Patients Undergoing Hemodialysis. , 2020, ss.215 - 220. 10.5152/turkjnephrol.2020.4130
AMA Hasbal N,koc y,sakaci t,Sevinc M,atan uçar z,Sahutoglu T,Akgol C,Ahbap E,unsal a,basturk t Prevalence and Characteristics of Atrial Fibrillation inTurkish Patients Undergoing Hemodialysis. . 2020; 215 - 220. 10.5152/turkjnephrol.2020.4130
Vancouver Hasbal N,koc y,sakaci t,Sevinc M,atan uçar z,Sahutoglu T,Akgol C,Ahbap E,unsal a,basturk t Prevalence and Characteristics of Atrial Fibrillation inTurkish Patients Undergoing Hemodialysis. . 2020; 215 - 220. 10.5152/turkjnephrol.2020.4130
IEEE Hasbal N,koc y,sakaci t,Sevinc M,atan uçar z,Sahutoglu T,Akgol C,Ahbap E,unsal a,basturk t "Prevalence and Characteristics of Atrial Fibrillation inTurkish Patients Undergoing Hemodialysis." , ss.215 - 220, 2020. 10.5152/turkjnephrol.2020.4130
ISNAD Hasbal, Nuri Baris vd. "Prevalence and Characteristics of Atrial Fibrillation inTurkish Patients Undergoing Hemodialysis". (2020), 215-220. https://doi.org/10.5152/turkjnephrol.2020.4130
APA Hasbal N, koc y, sakaci t, Sevinc M, atan uçar z, Sahutoglu T, Akgol C, Ahbap E, unsal a, basturk t (2020). Prevalence and Characteristics of Atrial Fibrillation inTurkish Patients Undergoing Hemodialysis. Turkish journal of nephrology (Online), 29(3), 215 - 220. 10.5152/turkjnephrol.2020.4130
Chicago Hasbal Nuri Baris,koc yener,sakaci tamer,Sevinc Mustafa,atan uçar zuhal,Sahutoglu Tuncay,Akgol Cuneyt,Ahbap Elbis,unsal abdulkadir,basturk taner Prevalence and Characteristics of Atrial Fibrillation inTurkish Patients Undergoing Hemodialysis. Turkish journal of nephrology (Online) 29, no.3 (2020): 215 - 220. 10.5152/turkjnephrol.2020.4130
MLA Hasbal Nuri Baris,koc yener,sakaci tamer,Sevinc Mustafa,atan uçar zuhal,Sahutoglu Tuncay,Akgol Cuneyt,Ahbap Elbis,unsal abdulkadir,basturk taner Prevalence and Characteristics of Atrial Fibrillation inTurkish Patients Undergoing Hemodialysis. Turkish journal of nephrology (Online), vol.29, no.3, 2020, ss.215 - 220. 10.5152/turkjnephrol.2020.4130
AMA Hasbal N,koc y,sakaci t,Sevinc M,atan uçar z,Sahutoglu T,Akgol C,Ahbap E,unsal a,basturk t Prevalence and Characteristics of Atrial Fibrillation inTurkish Patients Undergoing Hemodialysis. Turkish journal of nephrology (Online). 2020; 29(3): 215 - 220. 10.5152/turkjnephrol.2020.4130
Vancouver Hasbal N,koc y,sakaci t,Sevinc M,atan uçar z,Sahutoglu T,Akgol C,Ahbap E,unsal a,basturk t Prevalence and Characteristics of Atrial Fibrillation inTurkish Patients Undergoing Hemodialysis. Turkish journal of nephrology (Online). 2020; 29(3): 215 - 220. 10.5152/turkjnephrol.2020.4130
IEEE Hasbal N,koc y,sakaci t,Sevinc M,atan uçar z,Sahutoglu T,Akgol C,Ahbap E,unsal a,basturk t "Prevalence and Characteristics of Atrial Fibrillation inTurkish Patients Undergoing Hemodialysis." Turkish journal of nephrology (Online), 29, ss.215 - 220, 2020. 10.5152/turkjnephrol.2020.4130
ISNAD Hasbal, Nuri Baris vd. "Prevalence and Characteristics of Atrial Fibrillation inTurkish Patients Undergoing Hemodialysis". Turkish journal of nephrology (Online) 29/3 (2020), 215-220. https://doi.org/10.5152/turkjnephrol.2020.4130