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Sci Rep. 2017;7(1):6324.

Proteinuria Detected by Urine Dipstick Test as a Risk Factor for Atrial Fibrillation: A Nationwide Population-Based Study.

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제1저자 임우현 · 교신저자 최의근

소속 (5)
  1. Division of Cardiology, Department of Internal medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
  2. Division of Cardiology, Department of Internal medicine, Seoul National University Hospital, Seoul, Republic of Korea. choiek417@snu.ac.kr.
  3. Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
  4. Division of Cardiology, Department of Internal medicine, Seoul National University Hospital, Seoul, Republic of Korea.
  5. Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.

Abstract

Proteinuria is one of the well-known risk factors for cardiovascular disease. However the impact of proteinuria on the incidence of atrial fibrillation (AF) is unclear. In this study, we investigated the association between proteinuria detected using urine dipstick test and the risk of AF. A total of 18,201,275 individuals were analyzed, who had no prior AF and had received biennial health checkups provided by the National Health Insurance Service between 2005 and 2008 in Korea. Incidences of AF were ascertained through the end of 2015. During a mean follow-up of 9.6 years, a total of 324,764 (1.8%) developed AF (1.86 per 1,000 person-years). In Cox regression models, proteinuria was associated with an increased risk of AF: adjusted HR and 95% CI of AF occurrence were 1.13 (1.10-1.16), 1.34 (1.31-1.38), 1.53 (1.48-1.58), 1.82 (1.71-1.94), and 1.86 (1.61-2.16) in individuals with trace, 1+, 2+, 3+, and 4+ proteinuria, respectively, compared with those without proteinuria. The result was consistent even after additional adjustment for estimated glomerular filtration rate. In addition, the risk of AF further increased or decreased according to the follow-up dipstick test results. Thus, proteinuria measured with a dipstick test might be considered a potent risk factor for AF development.

Figures

Figure 1
Figure 1 Kaplan-Meier survival curves for freedom from atrial fibrillation. Subjects with higher levels of proteinuria were associated with a higher risk of atrial fibrillation during the follow-up period than those with lower levels of proteinuria.
Figure 2
Figure 2 Subgroup analysis. Graded risk of atrial fibrillation development according to the severity of dipstick proteinuria was consistent regardless of (A) age, (B) sex, (C) hypertension, (D) diabetes mellitus, and (E) chronic kidney disease. Hazard ratios were calculated using a Cox proportional model adjusted for age, sex, body mass index, smoking, alcohol consumption, exercise frequency, diabetes, hypertension, dyslipidemia, ischemic heart disease, congestive heart failure, stroke, and chronic obstructive pulmonary disease, except for the stratification variable. AF, atrial fibrillation; CKD, chronic kidney disease
Figure 3
Figure 3 The risk of atrial fibrillation (AF) according to the dipstick proteinuria and estimated glomerular filtration rate in the Follow-up Cohort. The positive correlation between atrial fibrillation development and the degree of dipstick proteinuria was consistent across all three categories of estimated glomerular filtration rate. Hazard ratios were calculated using a Cox proportional model adjusted for age, sex, body mass index, smoking, alcohol consumption, exercise frequency, diabetes, hypertension, dyslipidemia, ischemic heart disease, congestive heart failure, stroke, and chronic obstructive pulmonary disease. AF, atrial fibrillation; eGFR, estimated glomerular filtration rate

그림 출처: PubMed Central 공개 논문 (PMC5524798)

Conflict of interest statement

The authors declare that they have no competing interests.

그 밖의 정보
출판 형태
Journal Article, Research Support, Non-U.S. Gov't
저널
Scientific reports · eISSN 2045-2322
전자 출판
2017-07-24
MeSH
Adult · Aged · Atrial Fibrillation / epidemiology / etiology · Female · Glomerular Filtration Rate · Humans · Incidence · Male · Middle Aged · National Health Programs · Proportional Hazards Models · Proteinuria / complications / diagnosis / physiopathology · Regression Analysis · Republic of Korea · Risk Factors
참고문헌
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