Canadian Journal of Cardiology
Clinical Research| Volume 34, ISSUE 12, P1631-1640, December 2018

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

Published:August 28, 2018DOI:



      The risks and subsequent outcomes of syncope among seniors with chronic kidney disease (CKD) are unclear.


      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.


      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).


      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.



      On en connaît peu sur les risques et les issues de la syncope chez les personnes âgées atteintes d’une maladie rénale chronique.


      Nous avons mené une étude de cohorte rétrospective en population générale auprès de 272 146 patients ≥ 66 ans, en Ontario, au Canada, du 1er avril 2006 au 31 mars 2016. À l’aide des banques de données administratives sur les soins de santé, nous avons examiné l’association du taux de filtration glomérulaire estimé (TFGe) et du ratio albumine/créatinine (RAC) dans l’urine aux nouveaux cas de syncope, et l’association des nouveaux cas de syncope au critère composite d’infarctus du myocarde, d’accident vasculaire cérébral et de décès en fonction des taux de TFGe/RAC à l’aide des modèles à risques proportionnels de Cox ajustés.


      Un total de 15 074 nouveaux événements syncopaux sont survenus durant la période étudiée. Le risque ajusté de syncope était plus élevé lorsque le TFGe était plus faible et le RAC, plus élevé selon l’approche progressive (TFGe 60 à < 90 : RIA 1,17 [1,09-1,26] vs TFGe < 30 : RIA 1,67 [1,50-1,87] avec un TFGe ≥ valeur de référence de 90; RAC > 30 : RIA 1,15 [1,07-1,24] avec RAC < valeur de référence de 3). Parmi les 12 710 patients ayant subi une première syncope et ayant 1 an de suivi, le risque ajusté de critère combiné était plus élevé avec un TFGe plus faible et un RAC plus élevé selon l’approche progressive (TFGe de 60 à < 90 : RIA 1,05 [0,90-1,22] vs TFGe < 30 : RIA 1,62 [1,34-1,96] avec un TFGe ≥ valeur de référence de 90; RAC > 30 : RIA 1,77 [1,60-1,96], RAC < valeur de référence de 3).


      Un TFGe plus faible et un RAC plus élevé sont associés à un risque plus élevé de visites à l’hôpital pour une syncope et des complications associées chez les personnes d’un âge avancé.
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