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Estimated glomerular filtration rate derived from different formulas and prognosis in acute coronary syndrome: Findings from the improving care for cardiovascular disease in China-acute coronary syndrome project

Authors :
Ying-wen Lin
Jie-leng Huang
Xue-biao Wei
Mei Jiang
Peng Ran
Jie Li
Jia Qiu
Qi Zhong
Ying-ling Zhou
Ji-yan Chen
Dan-qing Yu
Source :
The American journal of the medical sciences. 364(5)
Publication Year :
2020

Abstract

The optimal formula for the estimation of glomerular filtration rate (GFR) in patients with acute coronary syndrome (ACS) in terms of predicting in-hospital mortality and adverse events remains unclear.A nationwide registry study, Improving CCC (Care for Cardiovascular Disease in China) ACS project, was launched in 2014 as a collaborative study of the American Heart Association and Chinese Society of Cardiology. The Cockcroft-Gault, modification of diet in renal disease (MDRD) formula for Chinese (C-MDRD), Mayo, and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formulas were used to calculate estimated GFR in 61,545 ACS patients (38,734 with ST-segment elevation myocardial infarction [STEMI] and 22,811 with non-ST-segment-elevation ACS [NSTE-ACS]).Prevalence of moderate to severe renal dysfunction was inconsistent among four formulas, ranging from 11.6% to 22.4% in NSTE-ACS and from 8.3% to 16.8% in STEMI, respectively. The in-hospital mortality rate in patients with ACS was inversely associated with estimated GFR. In STEMI, the Mayo-derived eGFR exhibited the highest predictive power for in-hospital death compared with the Cockcroft-Gault-derived eGFR (area under the curve [AUC]: 0.782 vs. 0.768, p=0.004), C-MDRD-derived eGFR (AUC: 0.782 vs. 0.740, p0.001) and CKD-EPI-derived eGFR (AUC: 0.782 vs. 0.767, p0.001). In NSTE-ACS, the Mayo-derived eGFR exhibited a similar predictive value with the Cockcroft-Gault (AUC: 0.781 vs. 0.787, p0.05) and CKD-EPI-derived eGFR (AUC: 0.781 vs. 0.784, p0.05).The Mayo formula was superior to Cockcroft-Gault, C-MDRD, and CKD-EPI formulas for predicting in-hospital mortality in ACS patients, especially for STEMI. The Mayo-derived eGFR may serve as a risk-stratification tool for in-hospital adverse events in ACS patients.URL: http://www.gov. Unique identifier: NCT02306616.

Details

ISSN :
15382990
Volume :
364
Issue :
5
Database :
OpenAIRE
Journal :
The American journal of the medical sciences
Accession number :
edsair.doi.dedup.....c9b04bbb16705ce91f8c4e49800eed6f