Cardiovascular risk among adults with chronic kidney disease, with or without prior myocardial infarction

Keattiyoat Wattanakit, Josef Coresh, Paul Muntner, Jane Marsh, Aaron R Folsom
Journal of the American College of Cardiology 2006 September 19, 48 (6): 1183-9

OBJECTIVES: This study sought to determine whether chronic kidney disease (CKD) should be considered a coronary heart disease (CHD) risk equivalent for cholesterol treatment.

BACKGROUND: It is unclear whether patients with CKD have a risk of CHD events or cardiovascular disease (CVD) mortality equivalent to patients with a prior myocardial infarction (MI).

METHODS: Using data from the ARIC (Atherosclerosis Risk in Communities) study, we categorized nondiabetic participants based on their average level of kidney function (estimated glomerular filtration rate > or =60 or 30 to 59 ml/min/1.73 m2, which defines stage 3 CKD) and on prior MI (yes or no). Rates and relative risks (RR) of CHD (MI or fatal CHD) events (n = 653) and CVD mortality (n = 209) that occurred over 10 years were compared across these populations.

RESULTS: Among 12,243 middle-age participants, 271 had stage 3 CKD. After adjustment for age, gender, race, and center, CHD incidence and CVD mortality rates per 1,000 person-years by presence of CKD and MI were 4.1 and 1.0 in the presence of neither condition, 8.0 and 3.4 in CKD only, 18.8 and 7.0 in MI only, and 30.8 and 18.0 in CKD and MI. After further adjustment for CVD risk factors, RR of CHD and CVD mortality were statistically significantly lower in subjects with CKD and no prior MI (RR = 0.44 [95% confidence interval (CI) 0.28 to 0.72] for CHD and RR = 0.46 [95% CI 0.24 to 0.90] for CVD mortality) than for subjects with no CKD and a prior MI.

CONCLUSIONS: Stage 3 CKD confers CHD risk that is lower and not equivalent to a prior MI in this middle-aged, general, nondiabetic population.


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Available on the App Store

Available on the Play Store
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"