Chronic kidney disease and undiagnosed atrial fibrillation in individuals with diabetes
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Cardiovascular Diabetology Open Access
ORIGINAL INVESTIGATION
Chronic kidney disease and undiagnosed atrial fibrillation in individuals with diabetes Nam Ju Heo1,3, Sang Youl Rhee2,3, Jill Waalen3 and Steven Steinhubl3*
Abstract Background: Diabetes is an independent risk factor for atrial fibrillation (AF), which is associated with increases in mortality and morbidity, as well as a diminished quality of life. Renal involvement in diabetes is common, and since chronic kidney disease (CKD) shares several of the same putative mechanisms as AF, it may contribute to its increased risk in individuals with diabetes. The objective of this study is to identify the relationship between CKD and the rates of newly-diagnosed AF in individuals with diabetes taking part in a screening program using a self-applied wearable electrocardiogram (ECG) patch. Materials and methods: The study included 608 individuals with a diagnosis of diabetes among 1738 total actively monitored participants in the prospective mHealth Screening to Prevent Strokes (mSToPS) trial. Participants, without a prior diagnosis of AF, wore an ECG patch for 2 weeks, twice, over a 4-months period and followed clinically through claims data for 1 year. Definitions of CKD included ICD-9 or ICD-10 chronic renal failure diagnostic codes, and the Health Profile Database algorithm. Individuals requiring dialysis were excluded from trial enrollment. Results: Ninety-six (15.8%) of study participants with diabetes also had a diagnosis of CKD. Over 12 months of followup, 19 new cases of AF were detected among the 608 participants. AF was newly diagnosed in 7.3% of participants with CKD and 2.3% in those without (P
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