Garcia-Gil, M;
Parramon, D;
Comas-Cufi, M;
Marti, R;
Ponjoan, A;
Alves-Cabratosa, L;
Blanch, J;
... Ramos, R; + view all
(2016)
Role of renal function in cardiovascular risk assessment: A retrospective cohort study in a population with low incidence of coronary heart disease.
Preventive Medicine
, 89
pp. 200-206.
10.1016/j.ypmed.2016.06.004.
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Abstract
BACKGROUND: Early-stage chronic kidney disease (CKD), a marker of cardiovascular risk, is susceptible to therapeutic intervention but need further study in populations with low incidence of coronary heart disease (CHD). Incorporating glomerular filtration rate (GFR) could improve cardiovascular risk prediction in these patients. OBJECTIVE: To determine if decreased GFR is associated with increased risk of cardiovascular morbidity and all-cause mortality and to analyse GFR effect on cardiovascular risk prediction in a population with low CHD incidence. METHODS: Retrospective, observational, population-based study of 1,081,865 adults (35–74 years old). Main exposure variable: GFR. Outcomes: CHD, cerebrovascular disease, cardiovascular diseases, all-cause mortality. Association between GFR categories of CKD (G1–G5) and outcomes was tested with Cox survival models. G1 was defined as the reference category. Predictive value of GFR was evaluated by integrated discrimination improvement (IDI) and net reclassification improvement (NRI) indices. RESULTS: Beginning at stage-3a CKD, increased risk was observed for coronary (HR 1.27 (95%CI 1.14–1.43)), cerebrovascular (HR 1.19 (95%CI 1.06–1.34)), cardiovascular (HR 1.23 (95%CI 1.13–1.34)) and all-cause mortality risk (HR 1.17 (95%CI 1.07–1.27)). GFR did not increase discrimination and reclassification indices significantly for any outcome. CONCLUSION: In general population with low CHD incidence and stage-3 CKD, impaired GFR was associated with increased risk of all cardiovascular diseases studied and all-cause mortality, but adding GFR values did not improve cardiovascular risk calculation. Despite a four-fold higher rate of CHD incidence at GFR G3a compared to G1, this represents moderate cardiovascular risk in our context.
| Type: | Article |
|---|---|
| Title: | Role of renal function in cardiovascular risk assessment: A retrospective cohort study in a population with low incidence of coronary heart disease |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.ypmed.2016.06.004 |
| Publisher version: | http://dx.doi.org/10.1016/j.ypmed.2016.06.004 |
| Language: | English |
| Additional information: | © 2016 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Public, Environmental & Occupational Health, Medicine, General & Internal, General & Internal Medicine, Primary Care, Cardiovascular Risk Assessment, Glomerular Filtration Rate, Electronic Medical Records, Glomerular-Filtration-Rate, Chronic Kidney-Disease, All-Cause Mortality, Primary-Care, Myocardial-Infarction, General-Population, Albuminuria, Information, Prevalence, Prevention |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1518985 |
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