Kidney function and specific mortality in 60-80 years old post-myocardial infarction patients: A 10-year follow-up study

Ellen K. Hoogeveen, Johanna M. Geleijnse, Erik J. Giltay, S.S. Soedamah-Muthu, Janette De Goede, Linda M. Oude Griep, Theo Stijnen, Daan Kromhout, Tatsuo Shimosawa (Editor)

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Abstract

Chronic kidney disease (CKD) is highly prevalent among older post-myocardial infarction (MI) patients. It is not known whether CKD is an independent risk factor for mortality in older post-MI patients with optimal cardiovascular drug-treatment. Therefore, we studied the relation between kidney function and all-cause and specific mortality among older post-MI patients, without severe heart failure, who are treated with state-of-the-art pharmacotherapy. From 2002–2006, 4,561 Dutch post-MI patients were enrolled and followed until death or January 2012. We estimated Glomerular Filtration Rate (eGFR) with cystatin C (cysC) and creatinine (cr) using the CKD-EPI equations and analyzed the relation with any and major causes of death using Cox models and restricted cubic splines. Mean (SD) for age was 69 years (5.6), 79% were men, 17% smoked, 21% had diabetes, 90% used antihypertensive drugs, 98% used antithrombotic drugs and 85% used statins. Patients were divided into four categories of baseline eGFRcysC: ≥90 (33%; reference), 60–89 (47%), 30–59 (18%), and <30 (2%) ml/min/1.73m2. Median follow-up was 6.4 years. During follow-up, 873 (19%) patients died: 370 (42%) from cardiovascular causes, 309 (35%) from cancer, and 194 (22%) from other causes. After adjustment for age, sex and classic cardiovascular risk factor, hazard ratios (95%-confidence intervals) for any death according to the four eGFRcysC categories were: 1 (reference), 1.4 (1.1–1.7), 2.9 (2.3–3.6) and 4.4 (3.0–6.4). The hazard ratios of all-cause and cause-specific mortality increased linearly below kidney functions of 80 ml/min/1.73 m2. Weaker results were obtained for eGFRcr. To conclude, we found in optimal cardiovascular drug-treated post-MI patients an inverse graded relation between kidney function and mortality for both cardiovascular as well as non-cardiovascular causes. Risk of mortality increased linearly below kidney function of about 80 ml/min/1.73 m2
Original languageEnglish
Article numbere0171868
JournalPLoS ONE
Volume12
Issue number2
DOIs
Publication statusPublished - 2017

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Kidney
Drug therapy
Cardiovascular Agents
Hazards
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Cystatin C
Medical problems
Splines
Antihypertensive Agents
Creatinine
Glomerular Filtration Rate
Proportional Hazards Models
Cause of Death
Pharmaceutical Preparations
Confidence Intervals
Neoplasms

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Hoogeveen, E. K., Geleijnse, J. M., Giltay, E. J., Soedamah-Muthu, S. S., De Goede, J., Oude Griep, L. M., ... Shimosawa, T. (Ed.) (2017). Kidney function and specific mortality in 60-80 years old post-myocardial infarction patients: A 10-year follow-up study. PLoS ONE, 12(2), [e0171868]. https://doi.org/10.1371/journal.pone.0171868
Hoogeveen, Ellen K. ; Geleijnse, Johanna M. ; Giltay, Erik J. ; Soedamah-Muthu, S.S. ; De Goede, Janette ; Oude Griep, Linda M. ; Stijnen, Theo ; Kromhout, Daan ; Shimosawa, Tatsuo (Editor). / Kidney function and specific mortality in 60-80 years old post-myocardial infarction patients : A 10-year follow-up study. In: PLoS ONE. 2017 ; Vol. 12, No. 2.
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abstract = "Chronic kidney disease (CKD) is highly prevalent among older post-myocardial infarction (MI) patients. It is not known whether CKD is an independent risk factor for mortality in older post-MI patients with optimal cardiovascular drug-treatment. Therefore, we studied the relation between kidney function and all-cause and specific mortality among older post-MI patients, without severe heart failure, who are treated with state-of-the-art pharmacotherapy. From 2002–2006, 4,561 Dutch post-MI patients were enrolled and followed until death or January 2012. We estimated Glomerular Filtration Rate (eGFR) with cystatin C (cysC) and creatinine (cr) using the CKD-EPI equations and analyzed the relation with any and major causes of death using Cox models and restricted cubic splines. Mean (SD) for age was 69 years (5.6), 79{\%} were men, 17{\%} smoked, 21{\%} had diabetes, 90{\%} used antihypertensive drugs, 98{\%} used antithrombotic drugs and 85{\%} used statins. Patients were divided into four categories of baseline eGFRcysC: ≥90 (33{\%}; reference), 60–89 (47{\%}), 30–59 (18{\%}), and <30 (2{\%}) ml/min/1.73m2. Median follow-up was 6.4 years. During follow-up, 873 (19{\%}) patients died: 370 (42{\%}) from cardiovascular causes, 309 (35{\%}) from cancer, and 194 (22{\%}) from other causes. After adjustment for age, sex and classic cardiovascular risk factor, hazard ratios (95{\%}-confidence intervals) for any death according to the four eGFRcysC categories were: 1 (reference), 1.4 (1.1–1.7), 2.9 (2.3–3.6) and 4.4 (3.0–6.4). The hazard ratios of all-cause and cause-specific mortality increased linearly below kidney functions of 80 ml/min/1.73 m2. Weaker results were obtained for eGFRcr. To conclude, we found in optimal cardiovascular drug-treated post-MI patients an inverse graded relation between kidney function and mortality for both cardiovascular as well as non-cardiovascular causes. Risk of mortality increased linearly below kidney function of about 80 ml/min/1.73 m2",
author = "Hoogeveen, {Ellen K.} and Geleijnse, {Johanna M.} and Giltay, {Erik J.} and S.S. Soedamah-Muthu and {De Goede}, Janette and {Oude Griep}, {Linda M.} and Theo Stijnen and Daan Kromhout and Tatsuo Shimosawa",
year = "2017",
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Hoogeveen, EK, Geleijnse, JM, Giltay, EJ, Soedamah-Muthu, SS, De Goede, J, Oude Griep, LM, Stijnen, T, Kromhout, D & Shimosawa, T (ed.) 2017, 'Kidney function and specific mortality in 60-80 years old post-myocardial infarction patients: A 10-year follow-up study', PLoS ONE, vol. 12, no. 2, e0171868. https://doi.org/10.1371/journal.pone.0171868

Kidney function and specific mortality in 60-80 years old post-myocardial infarction patients : A 10-year follow-up study. / Hoogeveen, Ellen K.; Geleijnse, Johanna M.; Giltay, Erik J.; Soedamah-Muthu, S.S.; De Goede, Janette; Oude Griep, Linda M.; Stijnen, Theo; Kromhout, Daan; Shimosawa, Tatsuo (Editor).

In: PLoS ONE, Vol. 12, No. 2, e0171868, 2017.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Kidney function and specific mortality in 60-80 years old post-myocardial infarction patients

T2 - A 10-year follow-up study

AU - Hoogeveen, Ellen K.

AU - Geleijnse, Johanna M.

AU - Giltay, Erik J.

AU - Soedamah-Muthu, S.S.

AU - De Goede, Janette

AU - Oude Griep, Linda M.

AU - Stijnen, Theo

AU - Kromhout, Daan

A2 - Shimosawa, Tatsuo

PY - 2017

Y1 - 2017

N2 - Chronic kidney disease (CKD) is highly prevalent among older post-myocardial infarction (MI) patients. It is not known whether CKD is an independent risk factor for mortality in older post-MI patients with optimal cardiovascular drug-treatment. Therefore, we studied the relation between kidney function and all-cause and specific mortality among older post-MI patients, without severe heart failure, who are treated with state-of-the-art pharmacotherapy. From 2002–2006, 4,561 Dutch post-MI patients were enrolled and followed until death or January 2012. We estimated Glomerular Filtration Rate (eGFR) with cystatin C (cysC) and creatinine (cr) using the CKD-EPI equations and analyzed the relation with any and major causes of death using Cox models and restricted cubic splines. Mean (SD) for age was 69 years (5.6), 79% were men, 17% smoked, 21% had diabetes, 90% used antihypertensive drugs, 98% used antithrombotic drugs and 85% used statins. Patients were divided into four categories of baseline eGFRcysC: ≥90 (33%; reference), 60–89 (47%), 30–59 (18%), and <30 (2%) ml/min/1.73m2. Median follow-up was 6.4 years. During follow-up, 873 (19%) patients died: 370 (42%) from cardiovascular causes, 309 (35%) from cancer, and 194 (22%) from other causes. After adjustment for age, sex and classic cardiovascular risk factor, hazard ratios (95%-confidence intervals) for any death according to the four eGFRcysC categories were: 1 (reference), 1.4 (1.1–1.7), 2.9 (2.3–3.6) and 4.4 (3.0–6.4). The hazard ratios of all-cause and cause-specific mortality increased linearly below kidney functions of 80 ml/min/1.73 m2. Weaker results were obtained for eGFRcr. To conclude, we found in optimal cardiovascular drug-treated post-MI patients an inverse graded relation between kidney function and mortality for both cardiovascular as well as non-cardiovascular causes. Risk of mortality increased linearly below kidney function of about 80 ml/min/1.73 m2

AB - Chronic kidney disease (CKD) is highly prevalent among older post-myocardial infarction (MI) patients. It is not known whether CKD is an independent risk factor for mortality in older post-MI patients with optimal cardiovascular drug-treatment. Therefore, we studied the relation between kidney function and all-cause and specific mortality among older post-MI patients, without severe heart failure, who are treated with state-of-the-art pharmacotherapy. From 2002–2006, 4,561 Dutch post-MI patients were enrolled and followed until death or January 2012. We estimated Glomerular Filtration Rate (eGFR) with cystatin C (cysC) and creatinine (cr) using the CKD-EPI equations and analyzed the relation with any and major causes of death using Cox models and restricted cubic splines. Mean (SD) for age was 69 years (5.6), 79% were men, 17% smoked, 21% had diabetes, 90% used antihypertensive drugs, 98% used antithrombotic drugs and 85% used statins. Patients were divided into four categories of baseline eGFRcysC: ≥90 (33%; reference), 60–89 (47%), 30–59 (18%), and <30 (2%) ml/min/1.73m2. Median follow-up was 6.4 years. During follow-up, 873 (19%) patients died: 370 (42%) from cardiovascular causes, 309 (35%) from cancer, and 194 (22%) from other causes. After adjustment for age, sex and classic cardiovascular risk factor, hazard ratios (95%-confidence intervals) for any death according to the four eGFRcysC categories were: 1 (reference), 1.4 (1.1–1.7), 2.9 (2.3–3.6) and 4.4 (3.0–6.4). The hazard ratios of all-cause and cause-specific mortality increased linearly below kidney functions of 80 ml/min/1.73 m2. Weaker results were obtained for eGFRcr. To conclude, we found in optimal cardiovascular drug-treated post-MI patients an inverse graded relation between kidney function and mortality for both cardiovascular as well as non-cardiovascular causes. Risk of mortality increased linearly below kidney function of about 80 ml/min/1.73 m2

U2 - 10.1371/journal.pone.0171868

DO - 10.1371/journal.pone.0171868

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JF - PLoS ONE

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