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Abstract: PO2074

Myeloperoxidase and the Risk of Atrial Fibrillation in the Chronic Renal Insufficiency Cohort (CRIC) Study

Session Information

Category: Hypertension and CVD

  • 1401 Hypertension and CVD: Epidemiology, Risk Factors, and Prevention

Authors

  • Curtis, Katherine, Brigham and Women's Hospital, Boston, Massachusetts, United States
  • Correa, Simon, Brigham and Women's Hospital, Boston, Massachusetts, United States
  • Waikar, Sushrut S., Boston Medical Center, Boston, Massachusetts, United States
  • McCausland, Finnian R., Brigham and Women's Hospital, Boston, Massachusetts, United States

Group or Team Name

  • Mc Causland Lab
Background

Myeloperoxidase (MPO) catalyzes the formation of reactive oxygen intermediates and is associated with adverse CV outcomes and progression of chronic kidney disease (CKD). We wished to determine the association of MPO with hospitalization for atrial fibrillation (AFib) in patients with baseline CKD.

Methods

We evaluated 3,872 participants with MPO measured at baseline in the CRIC Study, a large prospective multicenter cohort of non-dialysis dependent CKD. The association of MPO with hospitalization due to AFib was evaluated through adjusted Cox proportional hazard models in all study participants, and separately in subjects with and without AFib at baseline. Models were adjusted for age, sex, race, DM, SBP, coronary artery disease, CHF, eGFR (CKD-EPI), proteinuria, ACEi- ARB, beta-blocker and diuretic use.

Results

Mean age was 57.5 years, 55.2% were male and 40.4% were black. In the overall population, MPO was associated with a 15% higher risk of AFib hospitalization (aHR 1.15, 95% CI 1.05-1.27, per 1 SD log transformed MPO). The association of MPO with future Afib hospitalization was predominantly noted in those with a prior history of AFib (n=650; P-interaction<0.01), such that there was a 16% higher risk in those with baseline AFib (aHR 1.16, 95% CI 1.01-1.34, per 1 SD log transformed MPO) (Fig 1A), while there was no significant association for those without baseline Afib (aHR 1.11, 95% CI 0.97-1.28, per 1 SD log transformed MPO) (Fig 1B).

Conclusion

In patients with CKD, higher MPO was associated with an increased risk of hospitalization due to AFib, which appeared to be restricted to those with a prior AFib diagnosis. Whether therapies targeting MPO activity and oxidative stress in this population reduce AFib hospitalizations remains to be tested.