The prognostic importance of creatinine clearance after acute myocardial infarction
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The prognostic importance of creatinine clearance after acute myocardial infarction. / Sørensen, C R; Brendorp, B; Rask-Madsen, C; Køber, L; Kjøller, E; Torp-Pedersen, C.
I: European Heart Journal, Bind 23, Nr. 12, 2002, s. 948-52.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - The prognostic importance of creatinine clearance after acute myocardial infarction
AU - Sørensen, C R
AU - Brendorp, B
AU - Rask-Madsen, C
AU - Køber, L
AU - Kjøller, E
AU - Torp-Pedersen, C
N1 - Keywords: Adult; Aged; Cohort Studies; Creatinine; Double-Blind Method; Female; Follow-Up Studies; Humans; Kidney; Male; Middle Aged; Multivariate Analysis; Myocardial Infarction; Patient Admission; Predictive Value of Tests; Prognosis; Proportional Hazards Models; Risk Factors; Survival Analysis
PY - 2002
Y1 - 2002
N2 - AIMS: The purpose of this study was to assess renal dysfunction as an independent predictor of mortality after acute myocardial infarction. METHODS: The study population was 6252 patients with a myocardial infarction admitted alive from 1990 to 1992. The mortality status was obtained after at least 6 years. RESULTS: Cox proportional-hazards model demonstrated that the unadjusted risk ratio associated with a calculated creatinine clearance < or =40 ml x min(-1) compared to a clearance above 85 ml x min(-1) was 7.1 (95% confidence interval 6.2-8.0). Adjustment for multiple available covariates reduced this risk to 2.0 (1.6-2.4). The unadjusted risk ratio associated with clearance from 41 to 55 ml x min(-1) and from 71 to 85 ml x min(-1) was 3.7 (3.3-4.2) and 1.5 (1.3-1.7) respectively, but after adjustment for all available variables these risks were reduced to 1.4 (1.2-1.6) and 1.1 (0.9-1.3) respectively. CONCLUSION: Renal dysfunction is an important risk factor after acute myocardial infarction. When the risk is adjusted for available competing risk factors only severely reduced renal function is associated with an important and independent risk of mortality after acute myocardial infarction. The risk of a moderate reduction in renal function is almost fully explained by an association with other conditions.
AB - AIMS: The purpose of this study was to assess renal dysfunction as an independent predictor of mortality after acute myocardial infarction. METHODS: The study population was 6252 patients with a myocardial infarction admitted alive from 1990 to 1992. The mortality status was obtained after at least 6 years. RESULTS: Cox proportional-hazards model demonstrated that the unadjusted risk ratio associated with a calculated creatinine clearance < or =40 ml x min(-1) compared to a clearance above 85 ml x min(-1) was 7.1 (95% confidence interval 6.2-8.0). Adjustment for multiple available covariates reduced this risk to 2.0 (1.6-2.4). The unadjusted risk ratio associated with clearance from 41 to 55 ml x min(-1) and from 71 to 85 ml x min(-1) was 3.7 (3.3-4.2) and 1.5 (1.3-1.7) respectively, but after adjustment for all available variables these risks were reduced to 1.4 (1.2-1.6) and 1.1 (0.9-1.3) respectively. CONCLUSION: Renal dysfunction is an important risk factor after acute myocardial infarction. When the risk is adjusted for available competing risk factors only severely reduced renal function is associated with an important and independent risk of mortality after acute myocardial infarction. The risk of a moderate reduction in renal function is almost fully explained by an association with other conditions.
U2 - 10.1053/euhj.2001.2989
DO - 10.1053/euhj.2001.2989
M3 - Journal article
C2 - 12069449
VL - 23
SP - 948
EP - 952
JO - European Heart Journal
JF - European Heart Journal
SN - 0195-668X
IS - 12
ER -
ID: 17398941