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Renal function and short-term outcome in stable outpatients with coronary, cerebrovascular or peripheral artery disease.
MedLine Citation:
PMID:  23714334     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: The influence of renal function on outcome in stable outpatients with atherosclerotic disease has not been thoroughly studied. METHODS: We used the FRENA Registry data to compare the incidence of subsequent ischemic events (myocardial infarction [MI], ischemic stroke or limb amputation) in patients with coronary (CAD), cerebrovascular (CVD) or peripheral artery disease (PAD), according to their estimated glomerular filtration rate (eGFR) at baseline. RESULTS: As of April 2012, 3860 patients were recruited in FRENA: 1439 with CAD, 1118 with CVD and 1303 with PAD. Over a mean follow-up of 14±12 months, 97 patients suffered subsequent MI, 93 had ischemic stroke and 46 underwent limb amputation. In all, 2699 patients (70%) had eGFR>60mL/min/1.73m(2), 1022 (26%) had 30-60mL/min/1.73m(2), and 139 (3.6%) had <30mL/min/1.73m(2). Among patients with CAD, the rate of subsequent MI was: 1.38 (95% CI: 0.85-2.11), 5.79 (95% CI: 3.90-8.31) and 18.8 (95% CI: 9.14-34.4) events per 100 patient-years, respectively. On multivariable analysis, the hazard ratio for MI (compared with patients with eGFR>60mL/min/1.73m(2)) was of 1.77 (95% CI: 1.15-2.73) for patients with eGFR of 30-60mL/min/1.73m(2), and 3.15 (95% CI: 1.61-6.14) for those with eGFR<30mL/min/1.73m(2). Among patients with CVD or PAD, there was no increasing rate of subsequent ischemic events with decreasing renal function. CONCLUSIONS: Among stable outpatients with CAD, there is an increasing rate of subsequent MI with decreasing renal function, independently of potentially confounding variables. These findings were not observed in patients with CVD or PAD.
Authors:
Davide Bernaudo; Ramón Coll; Juan F Sánchez Muñoz-Torrero; María Teresa Pascual; Ana María García-Díaz; Lorenzo Ramón Alvarez; Manuel Monreal;
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-5-9
Journal Detail:
Title:  Atherosclerosis     Volume:  -     ISSN:  1879-1484     ISO Abbreviation:  Atherosclerosis     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-5-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0242543     Medline TA:  Atherosclerosis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.
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