The Case for Chronic Kidney Disease, Diabetes Mellitus, and Myocardial Infarction Being Equivalent Risk Factors for Cardiovascular Mortality in Patients Older Than 65 Years
The objective of the study was to determine whether chronic kidney disease (CKD) is as important a risk as either diabetes mellitus (DM) or previous myocardial infarction (MI). CKD and DM are important coronary artery disease risk factors. We hypothesized that the risk of cardiovascular mortality in...
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| Veröffentlicht in: | The American journal of cardiology 2008-12, Vol.102 (12), p.1668-1673 |
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| container_title | The American journal of cardiology |
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| creator | Rashidi, Arash, MD Sehgal, Ashwini Reddi, MD Rahman, Mahboob, MD, MS O' Connor, Andrew Stenson, DO, MPH |
| description | The objective of the study was to determine whether chronic kidney disease (CKD) is as important a risk as either diabetes mellitus (DM) or previous myocardial infarction (MI). CKD and DM are important coronary artery disease risk factors. We hypothesized that the risk of cardiovascular mortality in elderly patients with CKD is equivalent to that for patients with either DM or previous MI. The CHS limited-access database was used to identify a cohort of patients with a baseline history of MI, DM, or CKD (estimated glomerular filtration rate 65 years of age appears justified. |
| doi_str_mv | 10.1016/j.amjcard.2008.07.060 |
| format | Article |
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CKD and DM are important coronary artery disease risk factors. We hypothesized that the risk of cardiovascular mortality in elderly patients with CKD is equivalent to that for patients with either DM or previous MI. The CHS limited-access database was used to identify a cohort of patients with a baseline history of MI, DM, or CKD (estimated glomerular filtration rate <60 ml/min). Subjects were categorized in 1 of 3 groups as group 1, patients with DM (no CKD or MI); group 2, patients with previous MI (no DM or CKD); and group 3, patients with CKD (no DM or MI). Patients were followed up for a mean of 8.6 years, and rates of cardiovascular mortality were compared using proportional hazards regression. There were 789, 443, and 667 people in the MI, DM, and CKD groups, respectively. During follow-up, 124 patients (15.7%) died of cardiovascular causes in the MI group, and 69 (15.8%) and 87 (13%), in the DM and CKD groups, respectively. After adjusting for age, race, gender, smoking, hypertension, and total, high-density lipoprotein, and low-density lipoprotein cholesterol, the hazard ratio (HR) for cardiovascular mortality was similar between the DM (HR 1.0, 95% confidence interval 0.8 to 1.4)) and CKD cohorts (HR 0.8, 95% confidence interval 0.6 to 1.1) compared with the MI group. In conclusion, the risk of cardiovascular mortality in patients with moderate CKD was as high as that in patients with a history of MI or DM. Designation of CKD as a cardiovascular risk equivalent in patients >65 years of age appears justified.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2008.07.060</identifier><identifier>PMID: 19064021</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Biological and medical sciences ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Cardiovascular Diseases - mortality ; Coronary heart disease ; Diabetes ; Diabetes Complications ; Diabetes. Impaired glucose tolerance ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Female ; Heart ; Heart attacks ; Humans ; Kaplan-Meier Estimate ; Kidney diseases ; Kidneys ; Longitudinal Studies ; Male ; Medical sciences ; Mortality ; Myocardial Infarction - complications ; Nephrology ; Nephrology. Urinary tract diseases ; Nephropathies. Renovascular diseases. Renal failure ; Older people ; Poisson Distribution ; Proportional Hazards Models ; Renal failure ; Renal Insufficiency, Chronic - complications ; Risk Factors ; Urinary system involvement in other diseases. Miscellaneous</subject><ispartof>The American journal of cardiology, 2008-12, Vol.102 (12), p.1668-1673</ispartof><rights>Elsevier Inc.</rights><rights>2008 Elsevier Inc.</rights><rights>2009 INIST-CNRS</rights><rights>Copyright Elsevier Sequoia S.A. Dec 15, 2008</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c541t-8215baf42f503a2d08f5e4dd13da6598e27346b1be5c645c28efb95c0604ecdf3</citedby><cites>FETCH-LOGICAL-c541t-8215baf42f503a2d08f5e4dd13da6598e27346b1be5c645c28efb95c0604ecdf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.amjcard.2008.07.060$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20980057$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19064021$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rashidi, Arash, MD</creatorcontrib><creatorcontrib>Sehgal, Ashwini Reddi, MD</creatorcontrib><creatorcontrib>Rahman, Mahboob, MD, MS</creatorcontrib><creatorcontrib>O' Connor, Andrew Stenson, DO, MPH</creatorcontrib><title>The Case for Chronic Kidney Disease, Diabetes Mellitus, and Myocardial Infarction Being Equivalent Risk Factors for Cardiovascular Mortality in Patients Older Than 65 Years</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>The objective of the study was to determine whether chronic kidney disease (CKD) is as important a risk as either diabetes mellitus (DM) or previous myocardial infarction (MI). CKD and DM are important coronary artery disease risk factors. We hypothesized that the risk of cardiovascular mortality in elderly patients with CKD is equivalent to that for patients with either DM or previous MI. The CHS limited-access database was used to identify a cohort of patients with a baseline history of MI, DM, or CKD (estimated glomerular filtration rate <60 ml/min). Subjects were categorized in 1 of 3 groups as group 1, patients with DM (no CKD or MI); group 2, patients with previous MI (no DM or CKD); and group 3, patients with CKD (no DM or MI). Patients were followed up for a mean of 8.6 years, and rates of cardiovascular mortality were compared using proportional hazards regression. There were 789, 443, and 667 people in the MI, DM, and CKD groups, respectively. During follow-up, 124 patients (15.7%) died of cardiovascular causes in the MI group, and 69 (15.8%) and 87 (13%), in the DM and CKD groups, respectively. After adjusting for age, race, gender, smoking, hypertension, and total, high-density lipoprotein, and low-density lipoprotein cholesterol, the hazard ratio (HR) for cardiovascular mortality was similar between the DM (HR 1.0, 95% confidence interval 0.8 to 1.4)) and CKD cohorts (HR 0.8, 95% confidence interval 0.6 to 1.1) compared with the MI group. In conclusion, the risk of cardiovascular mortality in patients with moderate CKD was as high as that in patients with a history of MI or DM. Designation of CKD as a cardiovascular risk equivalent in patients >65 years of age appears justified.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Cardiovascular Diseases - mortality</subject><subject>Coronary heart disease</subject><subject>Diabetes</subject><subject>Diabetes Complications</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Etiopathogenesis. Screening. Investigations. Target tissue resistance</subject><subject>Female</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Kidney diseases</subject><subject>Kidneys</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Mortality</subject><subject>Myocardial Infarction - complications</subject><subject>Nephrology</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Nephropathies. Renovascular diseases. Renal failure</subject><subject>Older people</subject><subject>Poisson Distribution</subject><subject>Proportional Hazards Models</subject><subject>Renal failure</subject><subject>Renal Insufficiency, Chronic - complications</subject><subject>Risk Factors</subject><subject>Urinary system involvement in other diseases. 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Vascular system</topic><topic>Cardiovascular</topic><topic>Cardiovascular Diseases - mortality</topic><topic>Coronary heart disease</topic><topic>Diabetes</topic><topic>Diabetes Complications</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Etiopathogenesis. Screening. Investigations. Target tissue resistance</topic><topic>Female</topic><topic>Heart</topic><topic>Heart attacks</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Kidney diseases</topic><topic>Kidneys</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Mortality</topic><topic>Myocardial Infarction - complications</topic><topic>Nephrology</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Nephropathies. Renovascular diseases. Renal failure</topic><topic>Older people</topic><topic>Poisson Distribution</topic><topic>Proportional Hazards Models</topic><topic>Renal failure</topic><topic>Renal Insufficiency, Chronic - complications</topic><topic>Risk Factors</topic><topic>Urinary system involvement in other diseases. Miscellaneous</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rashidi, Arash, MD</creatorcontrib><creatorcontrib>Sehgal, Ashwini Reddi, MD</creatorcontrib><creatorcontrib>Rahman, Mahboob, MD, MS</creatorcontrib><creatorcontrib>O' Connor, Andrew Stenson, DO, MPH</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rashidi, Arash, MD</au><au>Sehgal, Ashwini Reddi, MD</au><au>Rahman, Mahboob, MD, MS</au><au>O' Connor, Andrew Stenson, DO, MPH</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Case for Chronic Kidney Disease, Diabetes Mellitus, and Myocardial Infarction Being Equivalent Risk Factors for Cardiovascular Mortality in Patients Older Than 65 Years</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2008-12-15</date><risdate>2008</risdate><volume>102</volume><issue>12</issue><spage>1668</spage><epage>1673</epage><pages>1668-1673</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>The objective of the study was to determine whether chronic kidney disease (CKD) is as important a risk as either diabetes mellitus (DM) or previous myocardial infarction (MI). CKD and DM are important coronary artery disease risk factors. We hypothesized that the risk of cardiovascular mortality in elderly patients with CKD is equivalent to that for patients with either DM or previous MI. The CHS limited-access database was used to identify a cohort of patients with a baseline history of MI, DM, or CKD (estimated glomerular filtration rate <60 ml/min). Subjects were categorized in 1 of 3 groups as group 1, patients with DM (no CKD or MI); group 2, patients with previous MI (no DM or CKD); and group 3, patients with CKD (no DM or MI). Patients were followed up for a mean of 8.6 years, and rates of cardiovascular mortality were compared using proportional hazards regression. There were 789, 443, and 667 people in the MI, DM, and CKD groups, respectively. During follow-up, 124 patients (15.7%) died of cardiovascular causes in the MI group, and 69 (15.8%) and 87 (13%), in the DM and CKD groups, respectively. After adjusting for age, race, gender, smoking, hypertension, and total, high-density lipoprotein, and low-density lipoprotein cholesterol, the hazard ratio (HR) for cardiovascular mortality was similar between the DM (HR 1.0, 95% confidence interval 0.8 to 1.4)) and CKD cohorts (HR 0.8, 95% confidence interval 0.6 to 1.1) compared with the MI group. In conclusion, the risk of cardiovascular mortality in patients with moderate CKD was as high as that in patients with a history of MI or DM. Designation of CKD as a cardiovascular risk equivalent in patients >65 years of age appears justified.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>19064021</pmid><doi>10.1016/j.amjcard.2008.07.060</doi><tpages>6</tpages></addata></record> |
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| subjects | Aged Biological and medical sciences Cardiology Cardiology. Vascular system Cardiovascular Cardiovascular Diseases - mortality Coronary heart disease Diabetes Diabetes Complications Diabetes. Impaired glucose tolerance Endocrine pancreas. Apud cells (diseases) Endocrinopathies Etiopathogenesis. Screening. Investigations. Target tissue resistance Female Heart Heart attacks Humans Kaplan-Meier Estimate Kidney diseases Kidneys Longitudinal Studies Male Medical sciences Mortality Myocardial Infarction - complications Nephrology Nephrology. Urinary tract diseases Nephropathies. Renovascular diseases. Renal failure Older people Poisson Distribution Proportional Hazards Models Renal failure Renal Insufficiency, Chronic - complications Risk Factors Urinary system involvement in other diseases. Miscellaneous |
| title | The Case for Chronic Kidney Disease, Diabetes Mellitus, and Myocardial Infarction Being Equivalent Risk Factors for Cardiovascular Mortality in Patients Older Than 65 Years |
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