BACKGROUND: The importance of chronic kidney disease as an independent risk factor for morbidity and mortality in patients with cardiovascular disease in the community is not widely recognized. METHODS: A retrospective cohort study based in the West of Ireland followed a randomized practice-based sample of patients with cardiovascular disease. A database of 1609 patients with established cardiovascular disease was established in 2000. This was generated from a randomized sample of 35 general practices in the West of Ireland. The primary endpoint was a cardiovascular composite endpoint, which included death from a cardiovascular cause or any of the cardiovascular events of myocardial infarction (MI), heart failure, peripheral vascular disease and stroke. The secondary endpoint was death from any cause. RESULTS: Of the original community-based cohort of 1609 patients with cardiovascular disease, 1272 (79%) had one or more serum creatinine measurements during the study period and 31 (1.9%) patients were lost to follow-up. Median follow-up was 2.90 years (SD 1.47) and the risk of the cardiovascular composite endpoint (total of 219 events) was significantly increased in those patients with reduced estimated glomerular filtration rate (GFR) [log rank (Mantel-Cox) 26.74, P<0.001] as was the risk of death from any cause (total of 214 deaths) [Log Rank (Mantel-Cox) 56.97, P<0.001]. On the basis of the proportional hazards model, while adjusting for other significant covariates, reduced estimated GFR was associated with a significant increase in risk of the primary and secondary outcomes (P<0.01). For every 10 ml decrement in estimated GFR there was a corresponding 20% increase in hazard of the cardiovascular composite endpoint and a 33% increase in hazard of death from any cause. CONCLUSIONS: Estimated GFR appears to discriminate prognosis between patients with established cardiovascular disease. These results emphasise the importance of recognising chronic kidney disease as a significant risk factor in patients with cardiovascular disease in the community.
BACKGROUND: The importance of chronic kidney disease as an independent risk factor for morbidity and mortality in patients with cardiovascular disease in the community is not widely recognized. METHODS: A retrospective cohort study based in the West of Ireland followed a randomized practice-based sample of patients with cardiovascular disease. A database of 1609 patients with established cardiovascular disease was established in 2000. This was generated from a randomized sample of 35 general practices in the West of Ireland. The primary endpoint was a cardiovascular composite endpoint, which included death from a cardiovascular cause or any of the cardiovascular events of myocardial infarction (MI), heart failure, peripheral vascular disease and stroke. The secondary endpoint was death from any cause. RESULTS: Of the original community-based cohort of 1609 patients with cardiovascular disease, 1272 (79%) had one or more serum creatinine measurements during the study period and 31 (1.9%) patients were lost to follow-up. Median follow-up was 2.90 years (SD 1.47) and the risk of the cardiovascular composite endpoint (total of 219 events) was significantly increased in those patients with reduced estimated glomerular filtration rate (GFR) [log rank (Mantel-Cox) 26.74, P<0.001] as was the risk of death from any cause (total of 214 deaths) [Log Rank (Mantel-Cox) 56.97, P<0.001]. On the basis of the proportional hazards model, while adjusting for other significant covariates, reduced estimated GFR was associated with a significant increase in risk of the primary and secondary outcomes (P<0.01). For every 10 ml decrement in estimated GFR there was a corresponding 20% increase in hazard of the cardiovascular composite endpoint and a 33% increase in hazard of death from any cause. CONCLUSIONS: Estimated GFR appears to discriminate prognosis between patients with established cardiovascular disease. These results emphasise the importance of recognising chronic kidney disease as a significant risk factor in patients with cardiovascular disease in the community.
Authors: Liam G Glynn; Brian Buckley; Donal Reddan; John Newell; John Hinde; Sean F Dinneen; Andrew W Murphy Journal: Br J Gen Pract Date: 2008-07 Impact factor: 5.386
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Authors: Jocelyn Anderson; Liam G Glynn; John Newell; Alberto A Iglesias; Donal Reddan; Andrew W Murphy Journal: BMC Cardiovasc Disord Date: 2009-11-12 Impact factor: 2.298
Authors: Daphne Eschbach; Christopher Bliemel; Ludwig Oberkircher; Rene Aigner; Juliana Hack; Benjamin Bockmann; Steffen Ruchholtz; Benjamin Buecking Journal: Biomed Res Int Date: 2016-01-13 Impact factor: 3.411