Abstract 4148059: Impact of Chronic Kidney Disease on Incidence of Atrial Fibrillation Following Heart Failure Exacerbation

Introduction: Chronic kidney disease (CKD) is associated with increased morbidity and mortality in patients with heart failure (HF). Patients with HF have a high prevalence of CKD, affecting 50% or more of those with either preserved or reduced ejection fraction HF. Both heart failure and chronic kidney disease are associated with an increased incidence of atrial fibrillation (AF). However, the impact of chronic kidney disease on the incidence of AF in the heart failure population is incompletely understood. Hypothesis: Patients with a history of CKD have a higher risk of developing AF following HF hospitalization. Aims: Our goal with this study was to examine whether chronic kidney disease impacts the development of AF following HF hospitalization. Methods: This retrospective study included consecutive patients who were admitted to an academic tertiary care center over a 3 year time period with a primary diagnosis of heart failure exacerbation and no prior diagnosis of AF. The primary outcome was an incident of AF within 12 months after hospitalization. Demographic, comorbidity, echocardiographic data, and medications were obtained. Cox-regression analysis was performed to identify the predictors of new atrial fibrillation following heart failure hospitalization. Results: A total of 2,087 patients with CKD and 1,866 patients without CKD were identified and included in our study. Of those with a previous diagnosis of CKD, 22.7% developed AF at one year, whereas this occurred in 13.2% of those without previous diagnosis of CKD. This difference was statistically significant after controlling for age and comorbidities ( p<0.001; RR 1.62; 95% CI 1.37-1.90) (Figure). Conclusion: A previous diagnosis of chronic kidney disease is a predictor of development of new atrial fibrillation at one year following heart failure hospitalization.