Chronic kidney disease has a graded association with death and cardiovascular outcomes in stable coronary artery disease : An analysis of 21,911 patients from the CLARIFY registry
Vidal-Petiot, Emmanuelle (Institut nationale de la santé et de la recherché médicale)
Greenlaw, Nicola (University of Glasgow)
Kalra, Paul R. (Portsmouth Hospitals NHS Trust)
Garcia-Moll, Xavier (Institut d'Investigació Biomèdica Sant Pau)
Tardif, Jean-Claude (Université de Montreal)
Ford, Ian (University of Glasgow)
Zamorano, José Luis (Hospital Universitario Ramón y Cajal (Madrid))
Ferrari, Roberto (Maria Cecilia Hospital)
Tendera, Michal (Medical University of Silesia)
Fox, Kim M. (Royal Brompton Hospital (Londres))
Steg, Philippe Gabriel (Hôpital Bichat)
Universitat Autònoma de Barcelona

Date:	2020
Abstract:	Chronic kidney disease (CKD) is associated with an increased cardiovascular risk in a broad spectrum of populations. However, the risk associated with a reduced estimated glomerular filtration rate (eGFR) in patients with stable coronary artery disease receiving standard care in the modern era, independently of baseline cardiovascular disease, risk factors, and comorbidities, remains unclear. We analyzed data from 21,911 patients with stable coronary artery disease, enrolled in 45 countries between November 2009 and July 2010 in the CLARIFY registry. Patients with abnormal renal function were older, with more comorbidities, and received slightly lower-although overall high-rates of evidence-based secondary prevention therapies than patients with normal renal function. The event rate of patients with CKD stage 3b or more (eGFR <45 mL/min/1. 73 m) was much higher than that associated with any comorbid condition. In a multivariable adjusted Cox proportional hazards model, lower eGFR was independently associated with a graded increased risk of cardiovascular mortality, with adjusted HRs (95% CI) of 0. 98 (0. 81-1. 18), 1. 31 (1. 05-1. 63), 1. 77 (1. 38-2. 27), and 3. 12 (2. 25-4. 33) for eGFR 60-89, 45-59, 30-44, and <30 mL/min/1. 73 m, compared with eGFR ≥90 mL/min/1. 73 m. A strong graded independent relationship exists between the degree of CKD and cardiovascular mortality in this large cohort of patients with chronic coronary artery disease, despite high rates of secondary prevention therapies. Among clinical risk factors and comorbid conditions, CKD stage 3b or more is associated with the highest cardiovascular mortality.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	CLARIFY registry ; Chronic coronary artery disease ; Chronic kidney disease
Published in:	Journal of clinical medicine, Vol. 9 Núm. 1 (january 2020) , p. 4, ISSN 2077-0383

DOI: 10.3390/jcm9010004
PMID: 31861379

15 p, 745.4 KB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles