Abstract

Background

Renal dysfunction leads to poor prognosis of patients with coronary artery disease (CAD). Current studies have reported the prognosis or mortality of various diseases using different estimated glomerular filtrate rate (eGFR) formulas, while the performance of these equations is unclear in CAD patients. We aim to evaluate the predict effect of creatinine-based eGFR (eGFRcr), cystatin C-based eGFR (eGFRcys), and both creatinine and cystatin C-based eGFR (eGFRcr-cys) in CAD patients.

Methods

A total of 23,178 patients with CAD were included from CIN-II cohort study. The association of eGFRcr, eGFRcys and eGFRcr-cys with cardiovascular and all-cause mortality was detected by Cox regression analysis. The predictive effect of eGFRcr, eGFRcys and eGFRcr-cys on mortality was assessed.

Results

During a median follow up of 4.3 years, totally 2051 patients (8.8%) experience all-cause mortality, of which 1427 patients (6.2%) died of cardiovascular disease. For the detection of cardiovascular mortality among CAD patients, eGFRcr-cys had high discriminatory capacity with area under the curve (AUC) in receiver operator characteristic analysis of 0.730, which was significantly better than eGFRcr (AUC = 0.707, p < 0.001) and eGFRcys (AUC = 0.719, p < 0.001). Similar results were observed in all-cause mortality. Restricted cubic spline showed a U-shaped association between eGFRcr and all outcomes in patients with both reduced and supranormal eGFR levels, while a L-shaped association in eGFRcys and eGFRcr-cys.

Conclusions

Estimated GFR based on both creatinine and cystatin C has highest predictive effect for cardiovascular and all-cause mortality among CAD patients. Meanwhile, supranormal eGFRcr may indicate a higher risk of mortality.

Details

Title
Predictive effect of estimated glomerular filtrate rate by creatinine or cystatin C on mortality in patients with coronary artery disease
Author
Chen, Shiqun 1 ; Zhou, Yang 2 ; Liang, Guoxiao 3 ; Wu, Wanying 2 ; Huang, Zhigang 4 ; Lile Shi 5 ; Gao, Yuwei 6 ; Gu, Xia 7 ; Wang, Dongmei 8 

 Global Health Research Center, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Science, Guangzhou, China; Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, China 
 Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Southern Medical University, China; Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China 
 Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Southern Medical University, China; Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China; Guangdong Medical University, Dongguan, China 
 Guangdong Medical University, Dongguan, China 
 Zhuhai People’s Hospital, Zhuhai hospital affiliated with Jinan University, Zhuhai, China 
 Zhuhai People’s Hospital, Zhuhai hospital affiliated with Jinan University, Zhuhai, China; Zhuhai People’s hospital, Jinan university, Zhuhai, China 
 Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, Heilongjiang, China; Cardiovascular Imaging Center, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China 
 Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Cadres Health Management Center, Guangzhou, China 
Publication year
2024
Publication date
Dec 2024
Publisher
Taylor & Francis Ltd.
ISSN
0886022X
e-ISSN
15256049
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3073446749
Copyright
© 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This work is licensed under the Creative Commons  Attribution – Non-Commercial License http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.