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Abstract: ASN Annual Meeting -- San Diego |
Kestenbaum BR, Rudser KD, Shlipak MG, et al.
Kidney Dysfunction, Electrocardiographic Findings, and Cardiovascular Events among Older Adults
ASN Annual Meeting -- San Diego
J Am Soc Nephrol (Nov) 17:368A 2006
Kidney dysfunction is associated with an increased risk of cardiovascular (CV) events and sudden death. It is not known whether specific ECG findings predict CV events in the setting of chronic kidney disease (CKD).
The Cardiovascular Health Study is a community-based study of adults aged 65 and over. Exclusions were atrial fibrillation, pacemaker, anti-arrhythmic medications, or missing ECG data. ECG markers were PR, QRS, and corrected QT intervals. CKD was defined by an estimated glomerular filtration rate <60 ml/min/1.73m2. Congestive heart failure (CHF) and coronary heart disease (CHD) were validated by medical record review.
Longer PR, QRS and QT intervals were highly prevalent among subjects with CKD. Renal-related differences in ECG measurements were attenuated by adjustment for prevalent CV disease and CV medications. Among subjects with CKD, each 10-ms increase in the QRS interval was associated with a 10% higher adjusted risk of incident CHF (95% CI 1.02, 1.18), and a 15% higher adjusted risk of incident CHD (95% CI 1.07, 1.25). Each 5% increase in the QT prolongation index was associated with a 34% higher risk of incident CHF (95% CI 1.19, 1.50) and 24% higher risk of incident CHD (95% CI 1.09, 1.40). Associations of ECG markers with CV events were modestly stronger among CKD participants, compared to the remainder of the study cohort; however, differences were not significantly different (p-for-interaction>0.05).
Abnormalities of the cardiac electrical cycle are common among individuals with impaired kidney function and predict incident CV events and mortality during long-term follow-up.
© Copyright 2006-2007, American Society of Nephrology. Reproduced with permission.
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