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Renal insufficiency as a predictor of cardiovascular outcomes and mortality in elderly individuals
- Source :
-
Journal of the American College of Cardiology (JACC) . Apr2003, Vol. 41 Issue 8, p1364-1372. 9p. - Publication Year :
- 2003
-
Abstract
- : ObjectivesThis study was designed to evaluate the relationship between elevated creatinine levels and cardiovascular events.: BackgroundEnd-stage renal disease is associated with high cardiovascular morbidity and mortality. The association of mild to moderate renal insufficiency with cardiovascular outcomes remains unclear.: MethodsWe analyzed data from the Cardiovascular Health Study, a prospective population-based study of subjects, aged >65 years, who had a serum creatinine measured at baseline (n = 5,808) and were followed for a median of 7.3 years. Proportional hazards models were used to examine the association of creatinine to all-cause mortality and incident cardiovascular mortality and morbidity. Renal insufficiency was defined as a creatinine level ≥1.5 mg/dl in men or ≥1.3 mg/dl in women.: ResultsAn elevated creatinine level was present in 648 (11.2%) participants. Subjects with elevated creatinine had higher overall (76.7 vs. 29.5/1,000 years, p < 0.001) and cardiovascular (35.8 vs. 13.0/1,000 years, p < 0.001) mortality than those with normal creatinine levels. They were more likely to develop cardiovascular disease (54.0 vs. 31.8/1,000 years, p < 0.001), stroke (21.1 vs. 11.9/1,000 years, p < 0.001), congestive heart failure (38.7 vs. 17/1,000 years, p < 0.001), and symptomatic peripheral vascular disease (10.6 vs. 3.5/1,000 years, p < 0.001). After adjusting for cardiovascular risk factors and subclinical disease measures, elevated creatinine remained a significant predictor of all-cause and cardiovascular mortality, total cardiovascular disease (CVD), claudication, and congestive heart failure (CHF). A linear increase in risk was observed with increasing creatinine.: ConclusionsElevated creatinine levels are common in older adults and are associated with increased risk of mortality, CVD, and CHF. The increased risk is apparent early in renal disease. [Copyright &y& Elsevier]
- Subjects :
- *CREATININE
*CARDIOVASCULAR diseases
*KIDNEY diseases
*CHRONIC kidney failure
*COMPARATIVE studies
*CONFIDENCE intervals
*HEART failure
*INTERMITTENT claudication
*RESEARCH methodology
*MEDICAL cooperation
*RESEARCH
*SURVIVAL analysis (Biometry)
*EVALUATION research
*PREDICTIVE tests
*ODDS ratio
CARDIOVASCULAR disease related mortality
CHRONIC kidney failure complications
Subjects
Details
- Language :
- English
- ISSN :
- 07351097
- Volume :
- 41
- Issue :
- 8
- Database :
- Academic Search Index
- Journal :
- Journal of the American College of Cardiology (JACC)
- Publication Type :
- Academic Journal
- Accession number :
- 9545896
- Full Text :
- https://doi.org/10.1016/S0735-1097(03)00163-3