Ann Geriatr Med Res.  2017 Mar;21(1):10-16. 10.4235/agmr.2017.21.1.10.

Predictive Value of Estimated Glomerular Filtration Rate for the Prognosis of Elderly Patients With Acute Myocardial Infarction

• Kim N
• Park HS
• Yoon JY
• Cho HJ
• Kim CY
• Roh JH
• Bae MH
• Lee JH
• Yang DH
• Cho Y
• Chae SC
• Sohn J
• Jang SY

• KMID: 2415666
• DOI: http://doi.org/10.4235/agmr.2017.21.1.10

Abstract

BACKGROUND
The aim of this study was to investigate the predictive value of estimated glomerular filtration rate (eGFR) calculated with the simplified Modification of Diet in Renal Disease (MDRD) Study and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations for prognosis in elderly patients with acute myocardial infarction (AMI).
METHODS
This study included 1,372 patients (mean age, 64.2±11.8 years; men, 67.9%) entered in the Kyungpook National University Hospital Acute Myocardial Infarction Registry from November 2005 to February 2010. We analyzed 1-year major adverse cardiac events (MACE) according to the eGFR calculated with the simplified MDRD Study and CKD-EPI equations.
RESULTS
The mean eGFR values calculated with the MDRD Study and CKD-EPI equations were 81.3±44.4 and 78.5±27.1 mL/(min/1.73 m²), respectively. In receiver operating characteristic curve analysis for prediction of 1-year MACE, the area under the curve based on the CKD-EPI equation was greater than that using the MDRD Study equation (CKD-EPI equation vs. MDRD Study equation: 0.691 vs. 0.674, p=0.041). Multivariate analysis using a Cox proportional hazards model revealed that the eGFR calculated with the CKD-EPI equation was an independent predictor of the occurrence of MACE within 1 year after AMI. However, eGFR calculated with the MDRD Study equation did not have predictive value. Furthermore, the eGFR calculated with the CKD-EPI equation had incremental prognostic value for established risk factors (chi-square=5.78, p=0.016).
CONCLUSION
The eGFR calculated using the CKD-EPI equation was an independent predictor of 1-year MACE in elderly patients with AMI.

Keyword

Myocardial infarction; Glomerular filtration rate; Major adverse cardiac event

MeSH Terms

Aged*
Cooperative Behavior
Diet
Epidemiology
Glomerular Filtration Rate*
Gyeongsangbuk-do
Humans
Male
Multivariate Analysis
Myocardial Infarction*
Prognosis*
Proportional Hazards Models
Renal Insufficiency, Chronic
Risk Factors
ROC Curve