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Difference in long-term prognostic value of renal function between ischemic and non-ischemic mild heart failure
Tom D J Smilde1, Hans L Hillege, Gerjan Navis
1Department of Cardiology, Thoraxcenter, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30001, 9700 RB Groningen, The Netherlands. t.d.j.smilde@thorax.umcg.nl
International Journal of Cardiology
|December 13, 2005
Summary
Renal function predicts mortality in mild non-ischemic heart failure but not in ischemic heart failure. This suggests renal vascular issues aren't the main driver of this prognostic link.
Area of Science:
- Cardiology
- Nephrology
- Internal Medicine
Background:
- Renal function is a key prognostic indicator in chronic heart failure.
- The prognostic value may be linked to renal vascular atherosclerosis.
- This study investigates renal function's prognostic role in ischemic versus non-ischemic heart failure.
Purpose of the Study:
- To assess the prognostic significance of renal function in mild chronic heart failure.
- To differentiate the prognostic value of renal function in ischemic and non-ischemic heart failure.
- To explore the underlying mechanisms of renal function's prognostic role.
Main Methods:
- Analysis of 161 patients with early chronic heart failure (NYHA class II).
- Categorization into ischemic (120 patients) and non-ischemic (41 patients) groups.
- Calculation of estimated glomerular filtration rate (GFRc) using the Cockcroft-Gault equation.
Main Results:
- Over 13 years, renal function predicted all-cause mortality in non-ischemic heart failure (RR 1.65, p=0.029).
- Renal function did not predict mortality in ischemic heart failure (RR 1.07, p=0.40).
- Baseline characteristics were similar between ischemic and non-ischemic groups.
Conclusions:
- Renal function is a prognostic marker for long-term mortality in non-ischemic mild heart failure.
- This prognostic value is not observed in patients with coronary artery disease (ischemic heart failure).
- Renal vascular abnormalities are unlikely the primary cause for renal function's prognostic role in mild heart failure.
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