Interleukin-6 Is a Risk Factor for Atrial Fibrillation in Chronic Kidney Disease: Findings from the CRIC Study

Richard L. Amdur, Biostatistics core, George Washington University Medical Faculty Associates, Washington, DC, United States of America.
Monica Mukherjee, Division of cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America.
Alan Go, Kaiser Permanente Division of Research, Oakland, CA, United States of America.
Ian R. Barrows, George Washington University School of Medicine, Washington, DC, United States of America.
Ali Ramezani, Division of Renal diseases and Hypertension, George Washington University School of Medicine, Washington, DC, United States of America.
Jun Shoji, Division of Renal diseases and Hypertension, George Washington University School of Medicine, Washington, DC, United States of America.
Muredach P. Reilly, Cardiovascular Institute, University of Pennsylvania, Philadelphia, PA, United States of America.
Joseph Gnanaraj, Bridgeport Hospital, Bridgeport, CT, United States of America.
Raj Deo, Cardiovascular Institute, University of Pennsylvania, Philadelphia, PA, United States of America.
Sylvia Roas, Harvard Medical School, Joslin Diabetes Center, Beth Israel Deaconess Medical Center, Boston, MA, United States of America.
Martin Keane, Temple Heart and Vascular Center, Philadelphia, PA, United States of America.
Steve Master, Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States of America.
Valerie Teal, Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States of America.
Elsayed Z. Soliman, Wake Forest University School of Medicine, Winston-Salem, NC, United States of America.
Peter Yang, Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States of America.
Harold Feldman, Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States of America.
John W. Kusek, National Institute of Diabetes and Digestive and Kidney Diseases, Division of Kidney, Urologic and Hematologic Diseases, Bethesda, MD, United States of America.
Cynthia M. Tracy, Division of Cardiology, George Washington University School of Medicine, Washington, DC, United States of America.
Dominic S. Raj, Division of Renal diseases and Hypertension, George Washington University School of Medicine, Washington, DC, United States of America.

Document Type

Article

Publication Title

PloS one

Abstract

Atrial fibrillation (AF) is the most common sustained arrhythmia in patients with chronic kidney disease (CKD). In this study, we examined the association between inflammation and AF in 3,762 adults with CKD, enrolled in the Chronic Renal Insufficiency Cohort (CRIC) study. AF was determined at baseline by self-report and electrocardiogram (ECG). Plasma concentrations of interleukin(IL)-1, IL-1 Receptor antagonist, IL-6, tumor necrosis factor (TNF)-α, transforming growth factor-β, high sensitivity C-Reactive protein, and fibrinogen, measured at baseline. At baseline, 642 subjects had history of AF, but only 44 had AF in ECG recording. During a mean follow-up of 3.7 years, 108 subjects developed new-onset AF. There was no significant association between inflammatory biomarkers and past history of AF. After adjustment for demographic characteristics, comorbid conditions, laboratory values, echocardiographic variables, and medication use, plasma IL-6 level was significantly associated with presence of AF at baseline (Odds ratio [OR], 1.61; 95% confidence interval [CI], 1.21 to 2.14; P = 0.001) and new-onset AF (OR, 1.25; 95% CI, 1.02 to 1.53; P = 0.03). To summarize, plasma IL-6 level is an independent and consistent predictor of AF in patients with CKD.

First Page

e0148189

DOI

10.1371/journal.pone.0148189

Publication Date

1-1-2016

Identifier

26840403 (pubmed); PMC4739587 (pmc); 10.1371/journal.pone.0148189 (doi); PONE-D-15-39171 (pii)

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