Prediction of cardiovascular outcome by estimated glomerular filtration rate and estimated creatinine clearance in the high-risk hypertension population of the VALUE trial
| Autor: | Ruilope, L. M., Zanchetti, A., Julius, S., Mcinnes, G. T., Segura, J., Stolt, P., Hua, T. A., Weber, M. A., Jamerson, K., Portaluppi, Francesco |
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| Jazyk: | angličtina |
| Rok vydání: | 2007 |
| Předmět: |
Male
medicine.medical_specialty Physiology Endpoint Determination Population Renal function urologic and male genital diseases law.invention chemistry.chemical_compound Randomized controlled trial law Predictive Value of Tests Risk Factors Internal medicine Internal Medicine medicine Odds Ratio Humans Risk factor Intensive care medicine education reproductive and urinary physiology Aged Creatinine education.field_of_study business.industry Odds ratio female genital diseases and pregnancy complications Proteinuria chemistry Cardiovascular Diseases Predictive value of tests Chronic Disease Hypertension Cardiology Female Kidney Diseases Cardiology and Cardiovascular Medicine business Value (mathematics) Glomerular Filtration Rate |
| Popis: | Reduced renal function is predictive of poor cardiovascular outcomes but the predictive value of different measures of renal function is uncertain.We compared the value of estimated creatinine clearance, using the Cockcroft-Gault formula, with that of estimated glomerular filtration rate (GFR), using the Modification of Diet in Renal Disease (MDRD) formula, as predictors of cardiovascular outcome in 15 245 high-risk hypertensive participants in the Valsartan Antihypertensive Long-term Use Evaluation (VALUE) trial. For the primary end-point, the three secondary end-points and for all-cause death, outcomes were compared for individuals with baseline estimated creatinine clearance and estimated GFR60 ml/min andor = 60 ml/min using hazard ratios and 95% confidence intervals. Coronary heart disease, left ventricular hypertrophy, age, sex and treatment effects were included as covariates in the model.For each end-point considered, the risk in individuals with poor renal function at baseline was greater than in those with better renal function. Estimated creatinine clearance (Cockcroft-Gault) was significantly predictive only of all-cause death [hazard ratio = 1.223, 95% confidence interval (CI) = 1.076-1.390; P = 0.0021] whereas estimated GFR was predictive of all outcomes except stroke. Hazard ratios (95% CIs) for estimated GFR were: primary cardiac end-point, 1.497 (1.332-1.682), P0.0001; myocardial infarction, 1.501 (1.254-1.796), P0.0001; congestive heart failure, 1.699 (1.435-2.013), P0.0001; stroke, 1.152 (0.952-1.394) P = 0.1452; and all-cause death, 1.231 (1.098-1.380), P = 0.0004.These results indicate that estimated glomerular filtration rate calculated with the MDRD formula is more informative than estimated creatinine clearance (Cockcroft-Gault) in the prediction of cardiovascular outcomes. |
| Databáze: | OpenAIRE |
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