Related Experiment Videos
Serum creatinine and coronary mortality in the elderly with normal renal function: the CArdiovascular STudy in the
Alberto Mazza1, Achille C Pessina, Valèrie Tikhonoff
1Department of Clinical and Experimental Medicine, University of Padua, Padua--Italy. alberto.mazza@unipd.it
Insights
Serum creatinine (SCr) independently predicts coronary heart disease (CHD) mortality in elderly men, even within normal ranges. This suggests sub-clinical kidney impairment may increase CHD risk in older men.
Area of Science:
- Cardiology
- Nephrology
- Geriatrics
Background:
- Elevated serum creatinine (SCr) is linked to increased mortality.
- The predictive value of SCr within normal ranges for coronary heart disease (CHD) mortality in the elderly is not well-established.
Purpose of the Study:
- To investigate whether SCr independently predicts CHD mortality in elderly individuals with SCr levels within the normal range.
Main Methods:
- A population-based cohort of 3,257 men and women aged 65+ years was studied.
- Historical, clinical, and blood test data were collected, along with 12-year fatal CHD events.
- Serum creatinine (SCr) and creatinine clearance (Crcl) were stratified into tertiles, and gender-specific relative risks (RR) for CHD mortality were calculated.
Main Results:
- Both SCr and Crcl independently predicted CHD mortality in men, but not in women.
- In men, CHD mortality increased with higher SCr tertiles (1.5%, 5.5%, 7.7%).
- In men, CHD mortality increased with decreasing Crcl tertiles (2.7%, 3.3%, 6.7%).
Conclusions:
- SCr is an independent predictor of CHD mortality in elderly men.
- SCr does not predict CHD mortality in elderly women.
- Normal-range SCr levels associated with increased CHD risk may indicate sub-clinical renal function impairment.
Background:
Elevated serum creatinine (SCr) levels have been associated with increased mortality. Aim of this study is to evaluate whether SCr independently predicts coronary heart disease (CHD) mortality in a population of elderly with SCr values within the normal range.
Methods:
Three thousand two hundred and fifty-seven men and women aged > or = 65 years were recruited in the population-based frame. Historical and clinical data, blood tests and 12-year fatal CHD events were recorded. SCr and creatinine clearance (Crcl) were divided into tertiles and, for each tertile, gender-specific adjusted relative risk (RR) with 95% confidence intervals (CI) for CHD mortality was calculated.
Results:
Both SCr and Crcl independently predicted CHD in men but not in women. In men CHD mortality increased with increasing SCr tertiles, being 1.5%, 5.5% (RR 2.51, CI 1.01-4.93) and 7.7% (RR 3.50, CI 1.41-5.88), respectively. The relationship between Crcl and CHD was inverse and increased with decreasing Crcl [2.7%, 3.3% (RR 1.42, CI 0.74-2.26) and 6.7% (RR 2.78, CI 1.56-4.12) in the 3rd, 2nd and 1st tertiles, respectively].
Conclusions:
SCr independently predicts CHD mortality in elderly men, but not in women. The increased CHD risk observed for SCr levels within the normal range is probably due to a sub-clinical impairment of renal function.
Related Concept Videos
Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration
Drug Dosing in Renal Diseases: Measurement of Serum Creatinine Concentration and Clearance
Serum Studies: Renal Function Tests
Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
Acute Kidney Injury IV: Diagnostic Studies and Prevention
Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT