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Prediction of cardiovascular outcome by estimated glomerular filtration rate and estimated creatinine clearance in the high-risk hypertension population of the VALUE trial.
J Hypertens. 2007 Jul; 25(7):1473-9.JH

Abstract

BACKGROUND

Reduced renal function is predictive of poor cardiovascular outcomes but the predictive value of different measures of renal function is uncertain.

METHODS

We compared the value of estimated creatinine clearance, using the Cockcroft-Gault formula, with that of estimated glomerular filtration rate (GFR), using the Modification of Diet in Renal Disease (MDRD) formula, as predictors of cardiovascular outcome in 15 245 high-risk hypertensive participants in the Valsartan Antihypertensive Long-term Use Evaluation (VALUE) trial. For the primary end-point, the three secondary end-points and for all-cause death, outcomes were compared for individuals with baseline estimated creatinine clearance and estimated GFR < 60 ml/min and > or = 60 ml/min using hazard ratios and 95% confidence intervals. Coronary heart disease, left ventricular hypertrophy, age, sex and treatment effects were included as covariates in the model.

RESULTS

For each end-point considered, the risk in individuals with poor renal function at baseline was greater than in those with better renal function. Estimated creatinine clearance (Cockcroft-Gault) was significantly predictive only of all-cause death [hazard ratio = 1.223, 95% confidence interval (CI) = 1.076-1.390; P = 0.0021] whereas estimated GFR was predictive of all outcomes except stroke. Hazard ratios (95% CIs) for estimated GFR were: primary cardiac end-point, 1.497 (1.332-1.682), P < 0.0001; myocardial infarction, 1.501 (1.254-1.796), P < 0.0001; congestive heart failure, 1.699 (1.435-2.013), P < 0.0001; stroke, 1.152 (0.952-1.394) P = 0.1452; and all-cause death, 1.231 (1.098-1.380), P = 0.0004.

CONCLUSION

These results indicate that estimated glomerular filtration rate calculated with the MDRD formula is more informative than estimated creatinine clearance (Cockcroft-Gault) in the prediction of cardiovascular outcomes.

Authors+Show Affiliations

Hypertension Unit, Hospital 12 de Octubre, Madrid, Spain. ruilope@ad-hocbox.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

17563571

Citation

Ruilope, Luis M., et al. "Prediction of Cardiovascular Outcome By Estimated Glomerular Filtration Rate and Estimated Creatinine Clearance in the High-risk Hypertension Population of the VALUE Trial." Journal of Hypertension, vol. 25, no. 7, 2007, pp. 1473-9.
Ruilope LM, Zanchetti A, Julius S, et al. Prediction of cardiovascular outcome by estimated glomerular filtration rate and estimated creatinine clearance in the high-risk hypertension population of the VALUE trial. J Hypertens. 2007;25(7):1473-9.
Ruilope, L. M., Zanchetti, A., Julius, S., McInnes, G. T., Segura, J., Stolt, P., Hua, T. A., Weber, M. A., & Jamerson, K. (2007). Prediction of cardiovascular outcome by estimated glomerular filtration rate and estimated creatinine clearance in the high-risk hypertension population of the VALUE trial. Journal of Hypertension, 25(7), 1473-9.
Ruilope LM, et al. Prediction of Cardiovascular Outcome By Estimated Glomerular Filtration Rate and Estimated Creatinine Clearance in the High-risk Hypertension Population of the VALUE Trial. J Hypertens. 2007;25(7):1473-9. PubMed PMID: 17563571.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prediction of cardiovascular outcome by estimated glomerular filtration rate and estimated creatinine clearance in the high-risk hypertension population of the VALUE trial. AU - Ruilope,Luis M, AU - Zanchetti,Alberto, AU - Julius,Stevo, AU - McInnes,Gordon T, AU - Segura,Julian, AU - Stolt,Pelle, AU - Hua,Tsushung A, AU - Weber,Michael A, AU - Jamerson,Ken, AU - ,, PY - 2007/6/15/pubmed PY - 2007/8/3/medline PY - 2007/6/15/entrez SP - 1473 EP - 9 JF - Journal of hypertension JO - J Hypertens VL - 25 IS - 7 N2 - BACKGROUND: Reduced renal function is predictive of poor cardiovascular outcomes but the predictive value of different measures of renal function is uncertain. METHODS: We compared the value of estimated creatinine clearance, using the Cockcroft-Gault formula, with that of estimated glomerular filtration rate (GFR), using the Modification of Diet in Renal Disease (MDRD) formula, as predictors of cardiovascular outcome in 15 245 high-risk hypertensive participants in the Valsartan Antihypertensive Long-term Use Evaluation (VALUE) trial. For the primary end-point, the three secondary end-points and for all-cause death, outcomes were compared for individuals with baseline estimated creatinine clearance and estimated GFR < 60 ml/min and > or = 60 ml/min using hazard ratios and 95% confidence intervals. Coronary heart disease, left ventricular hypertrophy, age, sex and treatment effects were included as covariates in the model. RESULTS: For each end-point considered, the risk in individuals with poor renal function at baseline was greater than in those with better renal function. Estimated creatinine clearance (Cockcroft-Gault) was significantly predictive only of all-cause death [hazard ratio = 1.223, 95% confidence interval (CI) = 1.076-1.390; P = 0.0021] whereas estimated GFR was predictive of all outcomes except stroke. Hazard ratios (95% CIs) for estimated GFR were: primary cardiac end-point, 1.497 (1.332-1.682), P < 0.0001; myocardial infarction, 1.501 (1.254-1.796), P < 0.0001; congestive heart failure, 1.699 (1.435-2.013), P < 0.0001; stroke, 1.152 (0.952-1.394) P = 0.1452; and all-cause death, 1.231 (1.098-1.380), P = 0.0004. CONCLUSION: These results indicate that estimated glomerular filtration rate calculated with the MDRD formula is more informative than estimated creatinine clearance (Cockcroft-Gault) in the prediction of cardiovascular outcomes. SN - 0263-6352 UR - https://www.unboundmedicine.com/medline/citation/17563571/Prediction_of_cardiovascular_outcome_by_estimated_glomerular_filtration_rate_and_estimated_creatinine_clearance_in_the_high_risk_hypertension_population_of_the_VALUE_trial_ L2 - https://doi.org/10.1097/HJH.0b013e328133246c DB - PRIME DP - Unbound Medicine ER -