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The Association of Kidney Function and Albuminuria With the Risk and Outcomes of Syncope: A Population-Based Cohort Study.

Publication ,  Journal Article
Massicotte-Azarniouch, D; Kuwornu, JP; McCallum, MK; Bansal, N; Lam, N; Molnar, AO; Pun, P; Zimmerman, D; Garg, AX; Sood, MM
Published in: Can J Cardiol
December 2018

BACKGROUND: The risks and subsequent outcomes of syncope among seniors with chronic kidney disease (CKD) are unclear. METHODS: We conducted a population-based retrospective cohort study of 272,146 patients ≥ 66 years old, in Ontario, Canada, from April 1, 2006, to March 31, 2016. Using administrative health care databases, we examined the association of estimated glomerular filtration rate (eGFR) and urine albumin to creatinine ratio (ACR) with incident syncope and the association of incident syncope with the composite outcome of myocardial infarction, stroke, and death by levels of eGFR/ACR, using adjusted Cox proportional hazards models. RESULTS: A total of 15,074 incident syncopal events occurred during the study period. The adjusted risk for syncope was higher with a lower eGFR and higher ACR in a stepwise manner (eGFR 60 to < 90: HR 1.17 [1.09-1.26] vs eGFR < 30: HR 1.67 (1.50-1.87) with eGFR ≥ 90 referent; ACR > 30: HR 1.15 [1.07-1.24] with ACR < 3 referent). Among the 12,710 patients with a first syncope event and 1 year of follow-up, the adjusted risk for the composite outcome was higher with a lower eGFR and higher ACR in a stepwise manner (eGFR 60 to < 90: HR 1.05 [0.90-1.22] vs eGFR < 30: HR 1.62 [1.34-1.96] with eGFR ≥ 90 referent; ACR > 30: HR 1.77 [1.60-1.96], ACR < 3 referent). CONCLUSIONS: A lower eGFR and higher ACR are associated with a higher risk of a hospital encounter for syncope and of related complications among persons of advanced age.

Duke Scholars

Published In

Can J Cardiol

DOI

EISSN

1916-7075

Publication Date

December 2018

Volume

34

Issue

12

Start / End Page

1631 / 1640

Location

England

Related Subject Headings

  • Syncope
  • Stroke
  • Retrospective Studies
  • Renal Insufficiency, Chronic
  • Proportional Hazards Models
  • Ontario
  • Myocardial Infarction
  • Male
  • Incidence
  • Humans
 

Citation

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Chicago
ICMJE
MLA
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Massicotte-Azarniouch, D., Kuwornu, J. P., McCallum, M. K., Bansal, N., Lam, N., Molnar, A. O., … Sood, M. M. (2018). The Association of Kidney Function and Albuminuria With the Risk and Outcomes of Syncope: A Population-Based Cohort Study. Can J Cardiol, 34(12), 1631–1640. https://doi.org/10.1016/j.cjca.2018.08.033
Massicotte-Azarniouch, David, John Paul Kuwornu, Megan K. McCallum, Nisha Bansal, Ngan Lam, Amber O. Molnar, Patrick Pun, Deborah Zimmerman, Amit X. Garg, and Manish M. Sood. “The Association of Kidney Function and Albuminuria With the Risk and Outcomes of Syncope: A Population-Based Cohort Study.Can J Cardiol 34, no. 12 (December 2018): 1631–40. https://doi.org/10.1016/j.cjca.2018.08.033.
Massicotte-Azarniouch D, Kuwornu JP, McCallum MK, Bansal N, Lam N, Molnar AO, et al. The Association of Kidney Function and Albuminuria With the Risk and Outcomes of Syncope: A Population-Based Cohort Study. Can J Cardiol. 2018 Dec;34(12):1631–40.
Massicotte-Azarniouch, David, et al. “The Association of Kidney Function and Albuminuria With the Risk and Outcomes of Syncope: A Population-Based Cohort Study.Can J Cardiol, vol. 34, no. 12, Dec. 2018, pp. 1631–40. Pubmed, doi:10.1016/j.cjca.2018.08.033.
Massicotte-Azarniouch D, Kuwornu JP, McCallum MK, Bansal N, Lam N, Molnar AO, Pun P, Zimmerman D, Garg AX, Sood MM. The Association of Kidney Function and Albuminuria With the Risk and Outcomes of Syncope: A Population-Based Cohort Study. Can J Cardiol. 2018 Dec;34(12):1631–1640.
Journal cover image

Published In

Can J Cardiol

DOI

EISSN

1916-7075

Publication Date

December 2018

Volume

34

Issue

12

Start / End Page

1631 / 1640

Location

England

Related Subject Headings

  • Syncope
  • Stroke
  • Retrospective Studies
  • Renal Insufficiency, Chronic
  • Proportional Hazards Models
  • Ontario
  • Myocardial Infarction
  • Male
  • Incidence
  • Humans