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Renal function and short-term outcome in stable outpatients with coronary, cerebrovascular or peripheral artery

Davide Bernaudo1, Ramón Coll, Juan F Sánchez Muñoz-Torrero

  • 1Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.

Atherosclerosis
|May 30, 2013
PubMed

Insights

Decreased kidney function significantly increases myocardial infarction risk in stable coronary artery disease (CAD) patients. This association was not found in patients with cerebrovascular (CVD) or peripheral artery disease (PAD).

Area of Science:

  • Cardiology
  • Nephrology
  • Vascular Medicine

Background:

  • Renal function's impact on outcomes in stable atherosclerotic disease patients is understudied.
  • Atherosclerotic disease encompasses coronary artery disease (CAD), cerebrovascular disease (CVD), and peripheral artery disease (PAD).

Purpose of the Study:

  • To investigate the relationship between estimated glomerular filtration rate (eGFR) and subsequent ischemic events in patients with CAD, CVD, or PAD.
  • To determine if renal function influences outcomes in stable outpatients with established atherosclerotic disease.

Main Methods:

  • Utilized data from the FRENA Registry, analyzing 3860 patients with CAD, CVD, or PAD.
  • Compared the incidence of myocardial infarction (MI), ischemic stroke, and limb amputation based on baseline eGFR levels.
  • Employed multivariable analysis to adjust for confounding variables.

Main Results:

  • In CAD patients, decreasing eGFR correlated with a higher rate of subsequent MI. Hazard ratios for MI increased with lower eGFR.
  • Patients with eGFR 30-60 mL/min/1.73 m(2) had a 1.77-fold increased risk of MI compared to those with eGFR > 60.
  • Patients with eGFR < 30 mL/min/1.73 m(2) had a 3.15-fold increased risk of MI.
  • No significant association between decreasing renal function and subsequent ischemic events was observed in CVD or PAD patients.

Conclusions:

  • Reduced renal function is an independent risk factor for subsequent myocardial infarction in stable coronary artery disease patients.
  • The association between renal function and ischemic events differs across atherosclerotic disease types (CAD vs. CVD/PAD).
  • These findings highlight the importance of assessing renal function in CAD management.
Abstract

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