Estimated Glomerular Filtration Rate in Short-Risk Stratification in Acute Myocardial Infarction

Blasco, María Luisa; Sanjuán, Rafael; Carbonell, Nieves; Solís, M. A. Gutiérrez; Puchades, María Jesús; Torregrosa, Isidro; Miguel, Juan A.

doi:10.1159/000327021

Cited by 10 publications

(12 citation statements)

References 49 publications

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“…Therefore, our data suggest that a moderately reduced eGFR is associated with additional cardiac stress in patients with established heart disease. This assumption is in agreement with the negative prognostic impact of a reduced eGFR following acute myocardial infarction and in chronic heart failure patients [14,15,16]. The mechanisms underlying the proposed interaction between renal function and cardiac stress cannot be determined from our study.…”

Section: Discussionsupporting

confidence: 87%

Elevated Levels of N-Terminal Pro-Brain Natriuretic Peptide in Patients with Chronic Dyspnea and Moderate Renal Dysfunction: Decreased Clearance or Increased Cardiac Stress

Wieshammer¹,

Dreyhaupt

Basler

2011

Cardiorenal Med

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Background/Aims: Serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) are often increased in patients with impaired renal function. The objective of this study was to investigate whether the increase in NT-proBNP is predominantly due to a reduced renal clearance or an increased cardiac secretion. Methods: A series of 697 outpatients (age: 57.5 ± 16.4 years) referred for evaluation of dyspnea were assigned to 4 groups according to their estimated glomerular filtration rate [eGFR (ml/min per 1.73 m²)]: group 1, eGFR <60 (n = 77); group 2, eGFR ≧60 to <75 (n = 139); group 3, eGFR ≧75 to <90 (n = 191), and group 4, eGFR ≧90 (n = 289). The patients were also grouped into 2 categories based on the presence (n = 176) or absence (n = 521) of heart disease. Results: In patients with heart disease, the adjusted values for NT-proBNP were higher in eGFR group 1 than in eGFR groups 2–4 (p ≤ 0.01). In patients without heart disease, eGFR group 1 membership had no effect on NT-proBNP. Conclusion: A reduced renal clearance does not explain increased NT-proBNP levels in patients with moderate renal impairment and dyspnea. Our data suggest that a moderate reduction in renal function places additional stress on the heart in patients with established cardiac disease.

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Section: Discussionsupporting

confidence: 87%

Elevated Levels of N-Terminal Pro-Brain Natriuretic Peptide in Patients with Chronic Dyspnea and Moderate Renal Dysfunction: Decreased Clearance or Increased Cardiac Stress

Wieshammer¹,

Dreyhaupt

Basler

2011

Cardiorenal Med

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“…Due to its lipid-lowering effect, the ε2 allele has been considered protective against coronary artery disease. Impaired renal function/CKD has been related to the risk of suffering heart failure [31]. Recent studies have identified associations between gene variants and heart failure which could be explained by an effect on renal function [32].…”

Section: Discussionmentioning

confidence: 99%

A Common <b><i>APOE</i></b> Polymorphism Is an Independent Risk Factor for Reduced Glomerular Filtration Rate in the Spanish RENASTUR Cohort

Coto¹,

Gómez²,

Tavira³

et al. 2013

Cardiorenal Med

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Objective:APOE gene variants may contribute to the risk of chronic kidney disease. Our aim was to determine whether the common APOE-ε2/ε3/ε4 polymorphism is associated with a reduced estimated glomerular filtration rate (eGFR) in the RENASTUR population, a cohort of elderly individuals from the region Asturias (northern Spain). Methods: A total of 743 Spanish Caucasians aged 55-85 years were genotyped for the APOE-ε2/ε3/ε4 polymorphism. Individuals with a previous diagnosis of renal disease were not eligible for the study. Participants with a documented history of type 2 diabetes mellitus (T2DM) or hypertension or who were receiving antidiabetic or antihypertensive drugswere classified as diabetics and hypertensives. The eGFR was calculated using the Modification of Diet in Renal Disease formula, and those with an eGFR <60 ml/min/1.73 m² (n = 91) were considered as having impaired renal function. The effect of alleles and genotypes on clinical (hypertension, T2DM) and analytical findings was statistically determined. Results: In addition to age and T2DM, APOE-ε2 was significantly associated with an eGFR <60 ml/min/1.73 m² (p = 0.002; OR = 2.30). This association remained statistically significant after correction for multiple variables. Although the effect of the APOE-ε2 allele on the eGFR was observed both among diabetics and nondiabetics, the significance was stronger in the T2DM group. Conclusion: The APOE-ε2 allele is a genetic risk factor for impaired renal function among healthy elderly Spanish individuals.

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“…Blasco et al . [ 25 ] evaluated 751 patients with acute MI admitted to a coronary care unit (CCU). Subjects with GFR lower than 60 ml/min/1.73m 2 were older, had greater comorbidities, congestive heart failure and higher mortality than those with GFR equal or greater than 60 ml/min/1.73m 2 .…”

Section: Discussionmentioning

confidence: 99%

Clinical Features of Cardio-Renal Syndrome in a Cohort of Consecutive Patients Admitted to an Internal Medicine Ward

Fabbian¹,

Pala²,

Giorgi³

et al. 2011

TOCMJ

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Introduction:Cardiorenal syndrome (CRS) is a disorder of the heart and kidney whereby interactions between the 2 organs can occur. We recorded the clinical features of CRS in patients consecutively admitted to an Internal Medicine ward.Patients and Methods:We retrospectively analyzed the anthropometric, history, clinical, biochemical and treatment characteristics in 438 out of 2,998 subjects (14.6%) admitted to our unit (from June 2007 to December 2009), diagnosed with CRS, according to Acute Dialysis Quality Initiative (ADQI) recommendations. Estimated glomerular filtration (eGFR) was calculated using several equations: MDRD (Modification of Diet in Renal Disease; 2 variations GFRMDRD186, GFRMDRD175), Mayo, Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Cockroft-Gault.Results:Mean age was 80±8 years, 222 (50.6%) were males, 321 (73.2%) were smokers, 229 (52.2%) were diabetic, 207 (47.2%) had a history of acute myocardial infarction, 167 (38.1%) had angina, 135 (30.8%) were affected by cerebrovascular disease, 339 (77.3%) had peripheral arterial disease. CRS was type 1 in 211 cases (48.2%), type 2 in 96 (21.9%), type 3 in 88 (20.1%), type 4 in 29 (6.6%) and type 5 in 14 (3.2%). eGFR, calculated by different formulae, ranged between 31 and 36 ml/min/1.73 m2. GFR was lower in CRS type 3 than in the other types, and the values ranged between 24 and 27 ml/min/1.73 m2. Mean hospital length-of-stay (LOS) was 9.8±6.3 days. Diuretics were the most prescribed medication (78.7%); only 5 patients underwent haemodialysis.Conclusions:CRS is common, especially in the elderly. CRS Type 1 was the prevalent subset and patients had stage 3-4 renal insufficiency. Results obtained from the GFR equations were similar although the Mayo equation tended to overestimate the eGFR.

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Estimated Glomerular Filtration Rate in Short-Risk Stratification in Acute Myocardial Infarction

Cited by 10 publications

References 49 publications

Elevated Levels of N-Terminal Pro-Brain Natriuretic Peptide in Patients with Chronic Dyspnea and Moderate Renal Dysfunction: Decreased Clearance or Increased Cardiac Stress

Elevated Levels of N-Terminal Pro-Brain Natriuretic Peptide in Patients with Chronic Dyspnea and Moderate Renal Dysfunction: Decreased Clearance or Increased Cardiac Stress

A Common <b><i>APOE</i></b> Polymorphism Is an Independent Risk Factor for Reduced Glomerular Filtration Rate in the Spanish RENASTUR Cohort

Clinical Features of Cardio-Renal Syndrome in a Cohort of Consecutive Patients Admitted to an Internal Medicine Ward

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