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Renal function and risk of myocardial infarction in an elderly population: the Rotterdam Study.
Arch Intern Med. 2005 Dec 12-26; 165(22):2659-65.AI

Abstract

BACKGROUND

Renal insufficiency is a risk factor for cardiovascular disease in patients with renal disease or coronary heart disease; however, it is unknown whether renal function is an independent predictor of cardiovascular disease in the general population.

METHODS

We investigated whether the level of renal function, estimated by glomerular filtration rate, was associated with the risk of incident myocardial infarction among 4484 apparently healthy subjects in the Rotterdam Study (mean age, 69.6 years). We estimated the glomerular filtration rate by Cockcroft-Gault and abbreviated modification of diet in renal disease equations and used Cox regression analysis to estimate hazard ratios adjusted for cardiovascular risk factors, atherosclerosis, and medication use.

RESULTS

During the follow-up period (mean, 8.6 years), 218 subjects (4.9%) had a myocardial infarction. A 10 mL/min per 1.73 m(2) decrease in glomerular filtration rate was associated with a 32% increased risk of myocardial infarction (P<.001). Compared with subjects in the fourth quartile, the multivariate-adjusted hazard ratios for the risk of myocardial infarction increased from 1.64 (95% confidence interval [CI], 1.03-2.59) in the third quartile to 1.94 (95% CI, 1.21-3.10) in the second quartile and 3.06 (95% CI, 1.80-5.19) in the quartile with the lowest glomerular filtration rate estimated by the Cockcroft-Gault equation. Using the abbreviated modification of diet in renal disease equation, the risk estimates for the third to first quartiles were 1.34 (95% CI, 0.89-2.01), 1.66 (95% CI, 1.14-2.49), and 1.90 (95% CI, 1.25-2.90), respectively.

CONCLUSIONS

The present study shows that renal function is a graded and independent predictor of the development of myocardial infarction in an elderly population. Early detection of decreased renal function may identify subjects who are at heightened risk of coronary heart disease.

Authors+Show Affiliations

Departments of Epidemiology and Biostatistics, Erasmus Medical Center, 3000 DR Rotterdam, the Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16344425

Citation

Brugts, Jasper J., et al. "Renal Function and Risk of Myocardial Infarction in an Elderly Population: the Rotterdam Study." Archives of Internal Medicine, vol. 165, no. 22, 2005, pp. 2659-65.
Brugts JJ, Knetsch AM, Mattace-Raso FU, et al. Renal function and risk of myocardial infarction in an elderly population: the Rotterdam Study. Arch Intern Med. 2005;165(22):2659-65.
Brugts, J. J., Knetsch, A. M., Mattace-Raso, F. U., Hofman, A., & Witteman, J. C. (2005). Renal function and risk of myocardial infarction in an elderly population: the Rotterdam Study. Archives of Internal Medicine, 165(22), 2659-65.
Brugts JJ, et al. Renal Function and Risk of Myocardial Infarction in an Elderly Population: the Rotterdam Study. Arch Intern Med. 2005 Dec 12-26;165(22):2659-65. PubMed PMID: 16344425.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Renal function and risk of myocardial infarction in an elderly population: the Rotterdam Study. AU - Brugts,Jasper J, AU - Knetsch,Annemarieke M, AU - Mattace-Raso,Francesco U S, AU - Hofman,Albert, AU - Witteman,Jacqueline C M, PY - 2005/12/14/pubmed PY - 2006/1/13/medline PY - 2005/12/14/entrez SP - 2659 EP - 65 JF - Archives of internal medicine JO - Arch Intern Med VL - 165 IS - 22 N2 - BACKGROUND: Renal insufficiency is a risk factor for cardiovascular disease in patients with renal disease or coronary heart disease; however, it is unknown whether renal function is an independent predictor of cardiovascular disease in the general population. METHODS: We investigated whether the level of renal function, estimated by glomerular filtration rate, was associated with the risk of incident myocardial infarction among 4484 apparently healthy subjects in the Rotterdam Study (mean age, 69.6 years). We estimated the glomerular filtration rate by Cockcroft-Gault and abbreviated modification of diet in renal disease equations and used Cox regression analysis to estimate hazard ratios adjusted for cardiovascular risk factors, atherosclerosis, and medication use. RESULTS: During the follow-up period (mean, 8.6 years), 218 subjects (4.9%) had a myocardial infarction. A 10 mL/min per 1.73 m(2) decrease in glomerular filtration rate was associated with a 32% increased risk of myocardial infarction (P<.001). Compared with subjects in the fourth quartile, the multivariate-adjusted hazard ratios for the risk of myocardial infarction increased from 1.64 (95% confidence interval [CI], 1.03-2.59) in the third quartile to 1.94 (95% CI, 1.21-3.10) in the second quartile and 3.06 (95% CI, 1.80-5.19) in the quartile with the lowest glomerular filtration rate estimated by the Cockcroft-Gault equation. Using the abbreviated modification of diet in renal disease equation, the risk estimates for the third to first quartiles were 1.34 (95% CI, 0.89-2.01), 1.66 (95% CI, 1.14-2.49), and 1.90 (95% CI, 1.25-2.90), respectively. CONCLUSIONS: The present study shows that renal function is a graded and independent predictor of the development of myocardial infarction in an elderly population. Early detection of decreased renal function may identify subjects who are at heightened risk of coronary heart disease. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/16344425/Renal_function_and_risk_of_myocardial_infarction_in_an_elderly_population:_the_Rotterdam_Study_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/archinte.165.22.2659 DB - PRIME DP - Unbound Medicine ER -