BACKGROUND: It is unclear whether pre-existing cardiovascular disease or predisposition of the uremic state leads to the high cardiovascular morbidity and mortality associated with renal failure. We examined whether renal failure independently increases the risk of myocardial infarction and death. METHODS: A total of 8600 patients with variable glomerular filtration rate (GFR) at the time of coronary angiography participated in the Intermountain Heart Study. Coronary disease was defined as >or=70% stenosis. Modification of Diet in Renal Disease formula was used to calculate glomerular filtration rate (GFR). Cox regression models were used to compare outcomes. RESULTS: The mean GFR was 71 +/- 24 mL/min. There were 1320 (15%) deaths, 657 (9%) myocardial infarctions and 1776 (21%) death or myocardial infarctions over 3.2 +/- 1.9 years. Compared to the highest GFR quartile, the lowest GFR quartile (mean GFR 41 +/- 14 mL/min) was associated with higher risk for myocardial infarction (RR 1.43, 95% CI 1.15 to 1.78), death (RR 2.77, 95% CI 2.32 to 3.30) and death/myocardial infarction (RR 2.13, 95% CI 1.85 to 2.45) in multivariable models adjusted for age, sex, hypertension, hyperlipidemia, smoking, family history of coronary disease and diabetes. Even after further adjustment for coronary angiographic data and the choice of initial therapy, lowest GFR quartile was associated with increased risk of myocardial infarction (RR 1.51, 95% CI 1.21 to 1.88), death (RR 2.60, 95% CI 2.18 to 3.10) and death/myocardial infarction (RR 2.08, 95% CI 1.80 to 2.39). CONCLUSIONS: Even moderate renal failure increases the risk of myocardial infarction and death independent of clinical variables, baseline angiographic evidence of coronary disease and therapy.
BACKGROUND: It is unclear whether pre-existing cardiovascular disease or predisposition of the uremic state leads to the high cardiovascular morbidity and mortality associated with renal failure. We examined whether renal failure independently increases the risk of myocardial infarction and death. METHODS: A total of 8600 patients with variable glomerular filtration rate (GFR) at the time of coronary angiography participated in the Intermountain Heart Study. Coronary disease was defined as >or=70% stenosis. Modification of Diet in Renal Disease formula was used to calculate glomerular filtration rate (GFR). Cox regression models were used to compare outcomes. RESULTS: The mean GFR was 71 +/- 24 mL/min. There were 1320 (15%) deaths, 657 (9%) myocardial infarctions and 1776 (21%) death or myocardial infarctions over 3.2 +/- 1.9 years. Compared to the highest GFR quartile, the lowest GFR quartile (mean GFR 41 +/- 14 mL/min) was associated with higher risk for myocardial infarction (RR 1.43, 95% CI 1.15 to 1.78), death (RR 2.77, 95% CI 2.32 to 3.30) and death/myocardial infarction (RR 2.13, 95% CI 1.85 to 2.45) in multivariable models adjusted for age, sex, hypertension, hyperlipidemia, smoking, family history of coronary disease and diabetes. Even after further adjustment for coronary angiographic data and the choice of initial therapy, lowest GFR quartile was associated with increased risk of myocardial infarction (RR 1.51, 95% CI 1.21 to 1.88), death (RR 2.60, 95% CI 2.18 to 3.10) and death/myocardial infarction (RR 2.08, 95% CI 1.80 to 2.39). CONCLUSIONS: Even moderate renal failure increases the risk of myocardial infarction and death independent of clinical variables, baseline angiographic evidence of coronary disease and therapy.
Authors: Vidya M Raj Krishnamurthy; Guo Wei; Bradley C Baird; Maureen Murtaugh; Michel B Chonchol; Kalani L Raphael; Tom Greene; Srinivasan Beddhu Journal: Kidney Int Date: 2011-10-19 Impact factor: 10.612
Authors: Vinod Jorapur; Gervasio A Lamas; Zygmunt P Sadowski; Harmony R Reynolds; Antonio C Carvalho; Christopher E Buller; James M Rankin; Jean Renkin; Philippe Gabriel Steg; Harvey D White; Carlos Vozzi; Eduardo Balcells; Michael Ragosta; C Edwin Martin; Vankeepuram S Srinivas; William W Wharton Iii; Staci Abramsky; Ana C Mon; Shari S Kronsberg; Judith S Hochman Journal: World J Cardiol Date: 2010-01-26
Authors: Joy Hsu; Kirsten L Johansen; Chi-Yuan Hsu; George A Kaysen; Glenn M Chertow Journal: Clin J Am Soc Nephrol Date: 2008-04-16 Impact factor: 8.237
Authors: Ye Jin Kim; Hong Jae Jeon; Yoo Hyung Kim; Jaewoong Jeon; Young Rok Ham; Sarah Chung; Dae Eun Choi; Ki Ryang Na; Kang Wook Lee Journal: Kidney Res Clin Pract Date: 2015-11-11