Abstract: Objective: To investigate whether chronic renal insufficiency is an independent risk factor or not for all-cause death, cardiac/cerebral disease death and thromboembolic events in patients with non-vavular atrial fibrillation aged over 45 years.Methods: Eight hundred and twenty-five non-vavular atrial fibrillation patients without anticoagulation therapy aged over 45 years were enrolled in this study. The average age of the patients was 76.52±11.80 years old, 18.91% of the patients was female, while 64.73% of the patients was over 75 years old. The baseline characteristics and adverse events during the observation period were recorded. Multivariate Cox regression analysis was adopted to calculate the adjusted hazard ratio (HR) of renal insufficiency for clinical adverse events.Results: During a median of 33.5 months' follow-up, 209 patients died of all-cause death, and 61 patients died of cardiac/cerebral disease death. A total of 139 patients had thromboembolic events (stroke or transient ischemic attack (TIA), or peripheral arterial thromboembolism). All of the adverse events were higher in atrial fibrillation patients with chronic renal insufficiency than those in control group (P<0.05). After adjustment for CHA2DS2-VASc score and other traditional risk factors, chronic renal insufficiency was also an independent predictor of the all-cause death, cardiac/cerebral disease death, thromboembolic events (P<0.05).Conclusion: After adjustment for CHA₂DS₂-VASc score, chronic renal insufficiency was one of the independent risk factors for all-cause death, cardiac/cerebral disease death, thromboembolic events in non-vavular atrial fibrillation patients aged over 45 years without anticoagulation therapy.

Key words: atrial fibrillation, chronic renal insufficiency, thromboembolic event, mortality