Estimated Glomerular Filtration Rate and Proteinuria Are Separately and Independently Associated with the Prevalence of Atrial Fibrillation in General Population

Background
Both, proteinuria and a decline in glomerular filtration rate (GFR) are associated with greater cardiovascular mortality. However, few studies have explored that proteinuria and lower GFR are related with prevalent atrial fibrillation (AF).
Methods
This cross-sectional study was based on annual health check-up program of community-based population in Gunma, Japan from April 2011 to March 2012. A total of 20,019 adult participants were included. AF was ascertained by a standard 12-lead electrocardiogram. Cross-sectional association and correlates with prevalent AF were examined using multivariable logistic regression analysis.
Results
The overall prevalence of AF was 0.6% (2.2 % in participants with eGFR < 60 mL▪min-1･1.73m-2, 0.4% and 0.2% in those with eGFR 60 to 89 and ≧90 mL▪min-1･1.73m-2, p for trend <0.001). The multivariable odds ratio (OR) for AF was 2.86 (95 % CI 1.16 - 7.08, p<0.001) for eGFR< 60 mL▪min-1▪1.73m-2 versus eGFR≧ 90 mL▪min-1▪1.73m-2. This association remained significant with further adjustment for proteinuria. In addition, proteinuria was also strongly associated with increased prevalence of AF (OR 2.96, 95 % CI 1.55-5.68, p<0.001), an association that remained significant after adjustment for eGFR.
Conclusions
Proteinuria and lower eGFR are separately and significantly associated with prevalence of AF independent of well-established risk factors for AF in general population.