Comparison of Risk Prediction With the CKD-EPI and MDRD Equations in Non–ST-Segment Elevation Acute Coronary Syndrome
Pedro J. Flores-Blanco,Ángel López-Cuenca,James L. Januzzi,Francisco Marín,Marianela Sánchez-Martínez,Miriam Quintana-Giner,Ana I. Romero-Aniorte,Mariano Valdés,Sergio Manzano-Fernández +8 more
TL;DR: Chronic Kidney Disease Epidemiology Collaboration equations estimate glomerular filtration rate (GFR) more accurately than the Modification of Diet in Renal Disease (MDRD) equation.
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Abstract: Background
Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations estimate glomerular filtration rate (GFR) more accurately than the Modification of Diet in Renal Disease (MDRD) equation.
Hypothesis
New CKD-EPI equations improve risk stratification in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and provide complementary information to the Global Registry of Acute Coronary Events (GRACE) risk score.
Methods
We studied 350 subjects (mean age, 68 ± 12 years; 70% male) with NSTE-ACS. Estimated GFR was calculated using the MDRD and new CKD-EPI equations based on serum creatinine (SCr) and/or cystatin C (CysC) concentrations obtained within 48 hours of hospital admission. The primary endpoint was all-cause death during follow-up.
Results
Over the study period (median, 648 days [interquartile range, 236–1042 days]), 31 patients died (0.05% events per person-year). Decedents had poorer renal-function parameters (P < 0.001). Both CysC-based CKD-EPI equations had the highest areas under the receiver operating characteristic curve for the prediction of all-cause mortality. After multivariate adjustment, only CysC-based CKD-EPI equations were independent predictors of all-cause mortality (CKD-EPISCr-CysC, per mL/min/1.73 m2: hazard ratio: 0.975, 95% confidence interval: 0.956-0.994, P = 0.009; CKD-EPICysC, per mL/min/1.73 m2: hazard ratio: 0.976, 95% confidence interval: 0.959-0.993, P = 0.005). Reclassification analyses showed that only CysC-based CKD-EPI equations improved predictive accuracy of the GRACE risk score.
Conclusions
In patients with NSTE-ACS, CysC-based CKD-EPI equations improved clinical risk stratification for mortality and added complementary prognostic information to the GRACE risk score.
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Citations
•Journal Article
A validated prediction model for all forms of acute coronary syndrome: Estimating the risk of 6-month postdischarge death in an international registry
Kim A. Eagle,Michael J. Lim,Omar H. Dabbous,Karen S. Pieper,Robert J. Goldberg,Frans Van de Werf,Shaun G. Goodman,Christopher B. Granger,P. Gabriel Steg,Joel M. Gore,Andrzej Budaj,Alvaro Avezum,Marcus Flather,Keith A.A. Fox,Rui Cruz Ferreira +14 more
TL;DR: The GRACE 6-month post-discharge prediction model is a simple, robust tool for predicting mortality in patients with acute coronary syndrome (ACS) from the Global Registry of Acute Coronary Events (GRACE) as discussed by the authors.
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Impact of Chronic Renal Failure on Ischemic and Bleeding Events at 1 Year in Patients With Acute Coronary Syndrome (from the Multicenter START ANTIPLATELET Registry).
Giuseppe Patti,Elisabetta Ricottini,Antonio Nenna,Ilaria Cavallari,Emilia Antonucci,Paolo Calabrò,Plinio Cirillo,Paolo Gresele,Gualtiero Palareti,Vittorio Pengo,Pasquale Pignatelli,Antonio Bisignani,Rossella Marcucci +12 more
TL;DR: It is indicated that, in patients with ACS, CRF impairs the clinical outcome at 1 year, especially when severe and when is concomitant with anemia.
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Relation of Serum and Urine Renal Biomarkers to Cardiovascular Risk in Patients with Type 2 Diabetes Mellitus and Recent Acute Coronary Syndromes (From the EXAMINE Trial).
Muthiah Vaduganathan,William B. White,David M. Charytan,David A. Morrow,Yuyin Liu,Faiez Zannad,Christopher P. Cannon,George L. Bakris,Examine Investigators +8 more
TL;DR: In conclusion, serum and urine renal biomarkers, when tested alone, independently predict long-term adverse CV events in high-risk patients with T2DM.
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Association Between the Serum Uric Acid Level and the Severity of Coronary Artery Disease in a Retrospective Study of China Nondialysis CKD Patients.
TL;DR: The SUA level may serve as a predictor of the severity of CAS among nondialysis CKD patients with CAD with CAD, and this relationship was not observed with SUA as a categorical variable.
6
One-year mortality of patients with ST-Elevation myocardial infarction: Prognostic impact of creatinine-based equations to estimate glomerular filtration rate
Yoann Bataille,Olivier Costerousse,Olivier F. Bertrand,Olivier Moranne,Hans Pottel,Pierre Delanaye +5 more
TL;DR: In STEMI patients who have undergone primary PCI, 1-year mortality is better predicted by CG or FAS equations compared to CKD-EPI, and better prediction with FAS and CG equations was confirmed by net reclassification index.
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