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Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Cardiovascular risk among adults with chronic kidney disease, with or without prior myocardial infarction

Keattiyoat Wattanakit1, Josef Coresh, Paul Muntner

  • 1Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota 55454-1015, USA.

Journal of the American College of Cardiology
|September 19, 2006
PubMed

Insights

Chronic kidney disease (CKD) is not a coronary heart disease (CHD) risk equivalent to a prior myocardial infarction (MI). This study found CKD confers lower CHD risk in a general, nondiabetic population.

Area of Science:

  • Cardiology
  • Nephrology
  • Epidemiology

Background:

  • Coronary heart disease (CHD) risk stratification is crucial for guiding cholesterol treatment.
  • The equivalence of chronic kidney disease (CKD) risk to established coronary heart disease (CHD) risk factors, such as prior myocardial infarction (MI), remains unclear.
  • Understanding these risk equivalencies is vital for effective cardiovascular disease (CVD) prevention strategies.

Purpose of the Study:

  • To determine if chronic kidney disease (CKD) should be classified as a coronary heart disease (CHD) risk equivalent for cholesterol management.
  • To compare the risk of CHD events and cardiovascular disease (CVD) mortality in patients with CKD versus those with a prior myocardial infarction (MI).

Main Methods:

  • Utilized data from the Atherosclerosis Risk in Communities (ARIC) study.
  • Nondiabetic participants were categorized by kidney function (estimated glomerular filtration rate) and history of prior myocardial infarction (MI).
  • Compared rates and relative risks (RR) of CHD events and CVD mortality over 10 years across defined participant groups.

Main Results:

  • Among 12,243 participants, 271 had stage 3 CKD.
  • After adjusting for confounders, individuals with CKD but no prior MI had significantly lower RR for CHD events (RR=0.44) and CVD mortality (RR=0.46) compared to those with prior MI and no CKD.
  • CHD incidence and CVD mortality rates were highest in individuals with both CKD and prior MI.

Conclusions:

  • Stage 3 CKD is associated with a lower coronary heart disease (CHD) risk than a prior myocardial infarction (MI).
  • In a middle-aged, general, nondiabetic population, CKD is not equivalent to prior MI in terms of CHD risk.
  • Findings suggest differential risk stratification may be appropriate for patients with CKD regarding cholesterol treatment.
Abstract

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