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Published on: May 10, 2013
Estimated Glomerular Filtration Rate and Mortality among Patients with Coronary Heart Disease
Qian Chen1,2, Yuan Zhang3, Ding Ding1
1Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China.
Insights
Reduced estimated glomerular filtration rate (eGFR) in Chinese patients with coronary heart disease (CHD) significantly increases the risk of both all-cause and cardiovascular disease (CVD) mortality. This finding highlights eGFR as a crucial predictor for adverse outcomes in this population.
Area of Science:
- Nephrology
- Cardiology
- Public Health
Background:
- The relationship between estimated glomerular filtration rate (eGFR) and mortality risk in coronary heart disease (CHD) patients is not fully understood.
- Assessing eGFR's impact on mortality prediction in Chinese CHD patients is crucial for risk stratification.
Purpose of the Study:
- To investigate the association between eGFR levels and the risk of all-cause and cardiovascular disease (CVD) mortality.
- To evaluate the predictive value of eGFR for mortality in Chinese patients with CHD.
Main Methods:
- A prospective cohort study involving 3276 Chinese patients with CHD.
- Cox proportional hazards regression models were employed to analyze the association between eGFR and mortality risk.
Main Results:
- Lower eGFR levels (<60 ml/min per 1.73m²) were significantly associated with increased all-cause and CVD mortality.
- Hazard ratios for all-cause mortality increased with decreasing eGFR: 1.28 (60-89), 1.96 (30-59), and 3.91 (15-29 ml/min per 1.73m²).
- eGFR addition significantly improved the prediction of all-cause and CVD mortality beyond traditional risk factors.
Conclusions:
- Reduced eGFR is a significant independent risk factor for increased all-cause and CVD mortality in Chinese CHD patients.
- eGFR measurement can enhance the risk prediction models for mortality in this patient group.
Objective:
The association between estimated glomerular filtration rate (eGFR) and the risk of mortality among patients with coronary heart disease (CHD) is complex and still unclear. The aim of this study was to evaluate the effect of eGFR on the risk prediction of all-cause and cardiovascular disease (CVD) mortality with a long follow-up period among patients with CHD in China.
Methods:
We conducted a prospective cohort study of 3276 Chinese patients with CHD. Cox proportional hazards regression models were used to estimate the association of different levels of eGFR with the risks of mortality.
Results:
During a mean follow-up period of 4.9 years, 293 deaths were identified. The multivariable-adjusted hazard ratios associated with different levels of eGFR (≥90 [reference group], 60-89, 30-59, 15-29 ml/min per 1.73m2) at baseline were 1.00, 1.28 (95% confidence interval [CI], 0.87-1.88), 1.96 (95% CI, 1.31-2.94), and 3.91 (95% CI, 2.15-7.13) (P <0.001) for all-cause mortality, and 1.00, 1.26 (95% CI, 0.78-2.04), 1.94 (95% CI, 1.17-3.20), and 3.77 (95% CI, 1.80-7.89) (P <0.001) for CVD mortality, respectively. After excluding subjects who died during the first 2 years of follow-up (n = 113), the graded associations of eGFR with the risks of all-cause and CVD morality were still present. The addition of eGFR to a model including traditional cardiovascular risk factors resulted in significant improvement in the prediction of all-cause and CVD mortality.
Conclusions:
Reduced eGFR (< 60 ml/min per 1.73 m2) at baseline is associated with increased risks of all-cause and CVD mortality among Chinese patients with CHD.
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