Chronic kidney disease classification according to different formulas and impact on adverse outcomes in patients with atrial fibrillation: A report from a prospective observational European registry
We included 8,506 patients. CKD-EPI demonstrated good to excellent concordance with other formulas, with the lowest concordance with CG (K = 0.607; 95% CI, 0.595-0.618) and the highest with MDRD (K = 0.880; 95% CI, 0.873-0.887). The risk of adverse outcomes increased sharply when renal function dropped below 60 ml/min across all formulas. CG-BSA and CG formulas showed the best discriminative ability for predicting composite outcomes (AUC 0.660, 95% CI 0.644-0.677, and 0.661, 95% CI 0.644-0.678, respectively). Based on integrated discrimination improvement (IDI) analysis, compared to the CKD-EPI equation, the CG and CG-BSA formulas showed significant improvements in sensitivity of 0.9% and 1.1%, respectively CONCLUSION: Equations for estimating renal function vary in concordance, with potential implications for drug prescription and predicting adverse events. CG and CG-BSA formulas showed superior performance in identifying patients at risk for adverse outcomes.
Authors
- Gheorghe‐Andrei Dan (ORCID: https://orcid.org/0000-0001-9867-2582)
- Igor Diemberger (ORCID: https://orcid.org/0000-0002-3823-3809)
- Marco Proietti (ORCID: https://orcid.org/0000-0003-1452-2478)
- Niccolò Bonini (ORCID: https://orcid.org/0000-0002-2766-5286)
- Gregory Y.H. Lip (ORCID: https://orcid.org/0000-0002-7566-1626)
- Marco Vitolo (ORCID: https://orcid.org/0000-0002-5196-6249)
- Tatjana Potpara (ORCID: https://orcid.org/0000-0001-6285-6902)
- Giulio Francesco Romiti (ORCID: https://orcid.org/0000-0002-3788-8942)
- Bernadette Corica (ORCID: https://orcid.org/0000-0001-9460-4435)
- Jacopo Francesco Imberti (ORCID: https://orcid.org/0000-0003-3403-3364)
- Davide Antonio Mei (ORCID: https://orcid.org/0009-0000-6345-3742)
- Giuseppe Boriani (ORCID: https://orcid.org/0000-0002-9820-4815)
Institutions
- University of Modena and Reggio Emilia (IT)
- University of Liverpool (GB)
- Carol Davila University of Medicine and Pharmacy (RO)
- University of Belgrade (RS)
- Liverpool Heart and Chest Hospital (GB)
- Istituti Clinici Scientifici Maugeri (IT)
- IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola (IT)
- Azienda Ospedaliero-Universitaria di Modena (IT)
- Centar za Promociju Nauke (RS)
- Liverpool John Moores University (GB)
- University of Bologna (IT)
Publication Details
- Journal
- European Journal of Internal Medicine
- Published
- 2025-05-05
- DOI
- https://doi.org/10.1016/j.ejim.2025.04.038
- Citations
- 8
- Primary Topic
- Atrial Fibrillation Management and Outcomes
- Type
- article
- Field-Weighted Citation Impact
- 11.11
Funders
- European Commission
- HORIZON EUROPE Framework Programme