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Creatinine levels and cardiovascular events in women with heart disease: do small changes matter?

Michael G Shlipak1, Catherine Stehman-Breen, Eric Vittinghoff

  • 1General Internal Medicine Section, Veterans Affairs Medical Center, San Francisco, CA 94121, USA. shlip@itsa.ucsf.edu

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|January 9, 2004
PubMed

Insights

Worsened kidney function did not predict cardiovascular events in women with coronary heart disease (CHD). However, baseline creatinine levels strongly predicted future CHD events in this population.

Area of Science:

  • Cardiology
  • Nephrology
  • Epidemiology

Background:

  • Small creatinine changes are linked to heart failure risk.
  • Association with cardiovascular events in established coronary heart disease (CHD) is unevaluated.

Purpose of the Study:

  • To evaluate the association of worsened renal function with cardiovascular events in postmenopausal women with established CHD.

Main Methods:

  • Observational study using data from the Heart and Estrogen/Progestin Replacement Study (HERS) and HERS-II follow-up.
  • 2,763 postmenopausal women with CHD were followed for a mean of 6.8 years.
  • Assessed the association of worsened renal function (creatinine increase ≥ 0.3 mg/dL) during HERS with CHD outcomes in HERS-II.

Main Results:

  • Only 9% of participants had worsened renal function, showing higher prevalence of diabetes and dyslipidemia.
  • Worsened renal function was initially associated with HERS-II CHD events (RH, 1.54; 95% CI, 1.04-2.29).
  • After adjustments, this association was no longer significant (RH, 1.08; 95% CI, 0.70-1.67), but baseline creatinine was a strong predictor of HERS-II events.

Conclusions:

  • Baseline renal function is a strong predictor of CHD events.
  • No significant association found between worsened renal function and cardiovascular outcomes after adjusting for risk factors and interim events.
Abstract

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