ORIGINAL RESEARCH
Association of Proteinuria and Incident Atrial Fibrillation in Patients With Intact and Reduced Kidney Function Amber O. Molnar, MD, MSc; Anan Bader Eddeen, MSc; Robin Ducharme, MPH; Amit X. Garg, MD, PhD; Ziv Harel, MD, MSc; Megan K. McCallum, MPH; Jeffrey Perl, MD, MSc; Ron Wald, MD, MSc; Deborah Zimmerman, MD, MSc; Manish M. Sood, MD
Background-—Early evidence suggests proteinuria is independently associated with incident atrial fibrillation (AF). We sought to investigate whether the association of proteinuria with incident AF is altered by kidney function. Methods and Results-—Retrospective cohort study using administrative healthcare databases in Ontario, Canada (2002–2015). A total of 736 666 patients aged ≥40 years not receiving dialysis and with no previous history of AF were included. Proteinuria was defined using the urine albumin-to-creatinine ratio (ACR) and kidney function by the estimated glomerular filtration rate (eGFR). The primary outcome was time to AF. Cox proportional models were used to determine the hazard ratio for AF censored for death, dialysis, kidney transplant, or end of follow-up. Fine and Grey models were used to determine the subdistribution hazard ratio for AF, with death as a competing event. Median follow-up was 6 years and 44 809 patients developed AF. In adjusted models, ACR and eGFR were associated with AF (P
Association of Proteinuria and Incident Atrial Fibrillation in Patients With Intact and Reduced Kidney Function Amber O. Molnar, MD, MSc; Anan Bader Eddeen, MSc; Robin Ducharme, MPH; Amit X. Garg, MD, PhD; Ziv Harel, MD, MSc; Megan K. McCallum, MPH; Jeffrey Perl, MD, MSc; Ron Wald, MD, MSc; Deborah Zimmerman, MD, MSc; Manish M. Sood, MD
Background-—Early evidence suggests proteinuria is independently associated with incident atrial fibrillation (AF). We sought to investigate whether the association of proteinuria with incident AF is altered by kidney function. Methods and Results-—Retrospective cohort study using administrative healthcare databases in Ontario, Canada (2002–2015). A total of 736 666 patients aged ≥40 years not receiving dialysis and with no previous history of AF were included. Proteinuria was defined using the urine albumin-to-creatinine ratio (ACR) and kidney function by the estimated glomerular filtration rate (eGFR). The primary outcome was time to AF. Cox proportional models were used to determine the hazard ratio for AF censored for death, dialysis, kidney transplant, or end of follow-up. Fine and Grey models were used to determine the subdistribution hazard ratio for AF, with death as a competing event. Median follow-up was 6 years and 44 809 patients developed AF. In adjusted models, ACR and eGFR were associated with AF (P
