Association between decreasing estimated glomerular filtration rate and risk of cardiac conduction defects in patients with type 2 diabetes

A Mantovani; R Rigolon; T Turino; I Pichiri; A Falceri; A Rossi; P L Temporelli; S Bonapace; G Lippi; G Zoppini; E Bonora; C D Byrne; G Targher

doi:10.1016/j.diabet.2018.08.007

Association between decreasing estimated glomerular filtration rate and risk of cardiac conduction defects in patients with type 2 diabetes

A Mantovani, R Rigolon, T Turino, I Pichiri, A Falceri, A Rossi, P L Temporelli, S Bonapace, G Lippi, G Zoppini, E Bonora, C D Byrne, G Targher

Research output: Contribution to journal › Article › peer-review

Abstract

AIM: We aimed to assess the association between decreasing estimated glomerular filtration rate (eGFR) or abnormal albuminuria and the risk of certain cardiac conduction defects in patients with type 2 diabetes mellitus (T2DM).

METHODS: We examined a hospital-based sample of 923 patients with T2DM discharged from our Division of Endocrinology over the years 2007-2014. Standard electrocardiograms (ECGs) were performed in all patients. eGFR was estimated by using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, whilst albuminuria was measured by an immuno-nephelometric method on morning spot urine samples.

RESULTS: A total of 253 (27.4%) patients had some type of cardiac conduction defects on standard ECGs (defined as at least one heart block among first-degree atrioventricular block, second-degree block, third-degree block, left bundle branch block, right bundle branch block, left anterior hemi-block or left posterior hemi-block). Prevalence of patients with eGFRCKD-EPI < 30 mL/min/1.73 m2, eGFRCKD-EPI 59-30 mL/min/1.73 m2 or abnormal albuminuria (i.e. urinary albumin-to-creatinine ratio ≥ 30 mg/g) were 7.0%, 29.4% and 41.3%, respectively. After adjustment for known cardiovascular risk factors, diabetes-related variables and potential confounders, there was a significant, graded association between decreasing eGFR values and risk of any cardiac conduction defects [adjusted-odds ratios of 2.05 (95% CI: 1.2-3.5), 2.85 (95% CI: 1.6-5.1) and 3.62 (95% CI: 1.6-8.1) for eGFRCKD-EPI 89-60, eGFRCKD-EPI 59-30 and eGFRCKD-EPI < 30 mL/min/1.73 m2, respectively]. Conversely, abnormal albuminuria was not independently associated with an increased risk of any conduction defects (adjusted-odds ratio: 1.09, 95% CI: 0.7-1.6).

CONCLUSION: Decreasing eGFR is independently associated with an increased risk of cardiac conduction defects in hospitalized patients with T2DM.

Original language	English
Pages (from-to)	473-481
Number of pages	9
Journal	Diabetes and Metabolism
Volume	44
Issue number	6
DOIs	https://doi.org/10.1016/j.diabet.2018.08.007
Publication status	Published - Dec 2018

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10.1016/j.diabet.2018.08.007

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Mantovani, A., Rigolon, R., Turino, T., Pichiri, I., Falceri, A., Rossi, A., Temporelli, P. L., Bonapace, S., Lippi, G., Zoppini, G., Bonora, E., Byrne, C. D., & Targher, G. (2018). Association between decreasing estimated glomerular filtration rate and risk of cardiac conduction defects in patients with type 2 diabetes. Diabetes and Metabolism, 44(6), 473-481. https://doi.org/10.1016/j.diabet.2018.08.007

Mantovani, A, Rigolon, R, Turino, T, Pichiri, I, Falceri, A, Rossi, A , Temporelli, PL, Bonapace, S, Lippi, G, Zoppini, G, Bonora, E, Byrne, CD & Targher, G 2018, 'Association between decreasing estimated glomerular filtration rate and risk of cardiac conduction defects in patients with type 2 diabetes', Diabetes and Metabolism, vol. 44, no. 6, pp. 473-481. https://doi.org/10.1016/j.diabet.2018.08.007

@article{fcc1d312ad604dca8077815e66c719ae,

title = "Association between decreasing estimated glomerular filtration rate and risk of cardiac conduction defects in patients with type 2 diabetes",

abstract = "AIM: We aimed to assess the association between decreasing estimated glomerular filtration rate (eGFR) or abnormal albuminuria and the risk of certain cardiac conduction defects in patients with type 2 diabetes mellitus (T2DM).METHODS: We examined a hospital-based sample of 923 patients with T2DM discharged from our Division of Endocrinology over the years 2007-2014. Standard electrocardiograms (ECGs) were performed in all patients. eGFR was estimated by using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, whilst albuminuria was measured by an immuno-nephelometric method on morning spot urine samples.RESULTS: A total of 253 (27.4%) patients had some type of cardiac conduction defects on standard ECGs (defined as at least one heart block among first-degree atrioventricular block, second-degree block, third-degree block, left bundle branch block, right bundle branch block, left anterior hemi-block or left posterior hemi-block). Prevalence of patients with eGFRCKD-EPI < 30 mL/min/1.73 m2, eGFRCKD-EPI 59-30 mL/min/1.73 m2 or abnormal albuminuria (i.e. urinary albumin-to-creatinine ratio ≥ 30 mg/g) were 7.0%, 29.4% and 41.3%, respectively. After adjustment for known cardiovascular risk factors, diabetes-related variables and potential confounders, there was a significant, graded association between decreasing eGFR values and risk of any cardiac conduction defects [adjusted-odds ratios of 2.05 (95% CI: 1.2-3.5), 2.85 (95% CI: 1.6-5.1) and 3.62 (95% CI: 1.6-8.1) for eGFRCKD-EPI 89-60, eGFRCKD-EPI 59-30 and eGFRCKD-EPI < 30 mL/min/1.73 m2, respectively]. Conversely, abnormal albuminuria was not independently associated with an increased risk of any conduction defects (adjusted-odds ratio: 1.09, 95% CI: 0.7-1.6).CONCLUSION: Decreasing eGFR is independently associated with an increased risk of cardiac conduction defects in hospitalized patients with T2DM.",

author = "A Mantovani and R Rigolon and T Turino and I Pichiri and A Falceri and A Rossi and Temporelli, {P L} and S Bonapace and G Lippi and G Zoppini and E Bonora and Byrne, {C D} and G Targher",

year = "2018",

month = dec,

doi = "10.1016/j.diabet.2018.08.007",

language = "English",

volume = "44",

pages = "473--481",

journal = "Diabetes and Metabolism",

issn = "1262-3636",

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TY - JOUR

T1 - Association between decreasing estimated glomerular filtration rate and risk of cardiac conduction defects in patients with type 2 diabetes

AU - Mantovani, A

AU - Rigolon, R

AU - Turino, T

AU - Pichiri, I

AU - Falceri, A

AU - Rossi, A

AU - Temporelli, P L

AU - Bonapace, S

AU - Lippi, G

AU - Zoppini, G

AU - Bonora, E

AU - Byrne, C D

AU - Targher, G

PY - 2018/12

Y1 - 2018/12

N2 - AIM: We aimed to assess the association between decreasing estimated glomerular filtration rate (eGFR) or abnormal albuminuria and the risk of certain cardiac conduction defects in patients with type 2 diabetes mellitus (T2DM).METHODS: We examined a hospital-based sample of 923 patients with T2DM discharged from our Division of Endocrinology over the years 2007-2014. Standard electrocardiograms (ECGs) were performed in all patients. eGFR was estimated by using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, whilst albuminuria was measured by an immuno-nephelometric method on morning spot urine samples.RESULTS: A total of 253 (27.4%) patients had some type of cardiac conduction defects on standard ECGs (defined as at least one heart block among first-degree atrioventricular block, second-degree block, third-degree block, left bundle branch block, right bundle branch block, left anterior hemi-block or left posterior hemi-block). Prevalence of patients with eGFRCKD-EPI < 30 mL/min/1.73 m2, eGFRCKD-EPI 59-30 mL/min/1.73 m2 or abnormal albuminuria (i.e. urinary albumin-to-creatinine ratio ≥ 30 mg/g) were 7.0%, 29.4% and 41.3%, respectively. After adjustment for known cardiovascular risk factors, diabetes-related variables and potential confounders, there was a significant, graded association between decreasing eGFR values and risk of any cardiac conduction defects [adjusted-odds ratios of 2.05 (95% CI: 1.2-3.5), 2.85 (95% CI: 1.6-5.1) and 3.62 (95% CI: 1.6-8.1) for eGFRCKD-EPI 89-60, eGFRCKD-EPI 59-30 and eGFRCKD-EPI < 30 mL/min/1.73 m2, respectively]. Conversely, abnormal albuminuria was not independently associated with an increased risk of any conduction defects (adjusted-odds ratio: 1.09, 95% CI: 0.7-1.6).CONCLUSION: Decreasing eGFR is independently associated with an increased risk of cardiac conduction defects in hospitalized patients with T2DM.

AB - AIM: We aimed to assess the association between decreasing estimated glomerular filtration rate (eGFR) or abnormal albuminuria and the risk of certain cardiac conduction defects in patients with type 2 diabetes mellitus (T2DM).METHODS: We examined a hospital-based sample of 923 patients with T2DM discharged from our Division of Endocrinology over the years 2007-2014. Standard electrocardiograms (ECGs) were performed in all patients. eGFR was estimated by using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, whilst albuminuria was measured by an immuno-nephelometric method on morning spot urine samples.RESULTS: A total of 253 (27.4%) patients had some type of cardiac conduction defects on standard ECGs (defined as at least one heart block among first-degree atrioventricular block, second-degree block, third-degree block, left bundle branch block, right bundle branch block, left anterior hemi-block or left posterior hemi-block). Prevalence of patients with eGFRCKD-EPI < 30 mL/min/1.73 m2, eGFRCKD-EPI 59-30 mL/min/1.73 m2 or abnormal albuminuria (i.e. urinary albumin-to-creatinine ratio ≥ 30 mg/g) were 7.0%, 29.4% and 41.3%, respectively. After adjustment for known cardiovascular risk factors, diabetes-related variables and potential confounders, there was a significant, graded association between decreasing eGFR values and risk of any cardiac conduction defects [adjusted-odds ratios of 2.05 (95% CI: 1.2-3.5), 2.85 (95% CI: 1.6-5.1) and 3.62 (95% CI: 1.6-8.1) for eGFRCKD-EPI 89-60, eGFRCKD-EPI 59-30 and eGFRCKD-EPI < 30 mL/min/1.73 m2, respectively]. Conversely, abnormal albuminuria was not independently associated with an increased risk of any conduction defects (adjusted-odds ratio: 1.09, 95% CI: 0.7-1.6).CONCLUSION: Decreasing eGFR is independently associated with an increased risk of cardiac conduction defects in hospitalized patients with T2DM.

U2 - 10.1016/j.diabet.2018.08.007

DO - 10.1016/j.diabet.2018.08.007

M3 - Article

C2 - 30195089

SN - 1262-3636

VL - 44

SP - 473

EP - 481

JO - Diabetes and Metabolism

JF - Diabetes and Metabolism

IS - 6

ER -

Association between decreasing estimated glomerular filtration rate and risk of cardiac conduction defects in patients with type 2 diabetes

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