Asymptomatic Ventricular Arrhythmia and Clinical Outcomes in Chronic Kidney Disease: A Pilot Study

Asymptomatic Ventricular Arrhythmia and Clinical Outcomes in Chronic Kidney Disease: A Pilot Study

Author Bonato, Fabiana Oliveira Bastos Autor UNIFESP Google Scholar
Watanabe, Renato Autor UNIFESP Google Scholar
Lemos, Marcelo Montebello Autor UNIFESP Google Scholar
Cassiolato, Jose Luiz Google Scholar
Wolf, Myles Google Scholar
Canziani, Maria Eugênia Fernandes Autor UNIFESP Google Scholar
Abstract Background/Aims: Ventricular arrhythmia is associated with increased risk of cardiovascular events and death in the general population. Sudden death is a leading cause of death in end-stage renal disease. We aimed at evaluating the effects of ventricular arrhythmia on clinical outcomes in patients with earlier stages of chronic kidney disease (CKD). Methods: In a prospective study of 109 nondialyzed CKD patients (estimated glomerular filtration rate 34.8 +/- 16.1 ml/min/1.73 m(2), 57 +/- 11.4 years, 61% male, 24% diabetics), we tested the hypothesis that the presence of subclinical complex ventricular arrhythmia, assessed by 24-hour electrocardiogram, is associated with increased risks of cardiovascular events, hospitalization, and death and with their composite outcome during 24 months of follow-up. Complex ventricular arrhythmia was defined as the presence of multifocal ventricular extrasystoles, paired ventricular extrasystoles, nonsustained ventricular tachycardia, or R wave over T wave. Results: We identified complex ventricular arrhythmia in 14% of participants at baseline. During follow-up, 11 cardiovascular events, 15 hospitalizations, and 4 deaths occurred. The presence of complex ventricular arrhythmia was associated with cardiovascular events (p < 0.001), hospitalization (p = 0.018), mortality (p < 0.001), and the composite outcome (p < 0.001). In multivariate Cox regression analysis, adjusting for demographic characteristics, complex ventricular arrhythmia was associated with increased risk of the composite outcome (HR 4.40

95% CI 1.60-12.12

p = 0.004). Conclusion: In this pilot study, the presence of asymptomatic complex ventricular arrhythmia was associated with poor clinical outcomes in nondialyzed CKD patients. (C) 2016 S. Karger AG, Basel
Keywords Ventricular arrhythmia
Cardiac arrhythmia
Cardiovascular disease
Chronic kidney disease
xmlui.dri2xhtml.METS-1.0.item-coverage Basel
Language English
Date 2017
Published in Cardiorenal Medicine. Basel, v. 7, n. 1, p. 66-73, 2017.
ISSN 1664-3828 (Sherpa/Romeo, impact factor)
Publisher Karger
Extent 66-73
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000389244900008

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