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Disparities in the Estimation of Glomerular Filtration Rate According to Cockcroft‐Gault, Modification of Diet in Renal Disease‐4, and Chronic Kidney Disease Epidemiology Collaboration Equations and Relation With Outcomes in Patients With Acute Coronary Syndrome

BACKGROUND: A simple method to assess renal function is the estimated glomerular filtration rate, and it shows prognostic implications. However, it remains unknown which equation should be used in patients with acute coronary syndrome. We compared the ability and correlation of the Cockcroft‐Gault,...

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Autores principales: Rivera‐Caravaca, José Miguel, Ruiz‐Nodar, Juan Miguel, Tello‐Montoliu, Antonio, Esteve‐Pastor, María Asunción, Quintana‐Giner, Miriam, Véliz‐Martínez, Andrea, Orenes‐Piñero, Esteban, Romero‐Aniorte, Ana Isabel, Vicente‐Ibarra, Nuria, Pernias‐Escrig, Vicente, Carrillo‐Alemán, Luna, Candela‐Sánchez, Elena, Hortelano, Ignacio, Villamía, Beatriz, Sandín‐Rollán, Miriam, Nuñez‐Martínez, Laura, Valdés, Mariano, Marín, Francisco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6015275/
https://www.ncbi.nlm.nih.gov/pubmed/29680822
http://dx.doi.org/10.1161/JAHA.118.008725
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author Rivera‐Caravaca, José Miguel
Ruiz‐Nodar, Juan Miguel
Tello‐Montoliu, Antonio
Esteve‐Pastor, María Asunción
Quintana‐Giner, Miriam
Véliz‐Martínez, Andrea
Orenes‐Piñero, Esteban
Romero‐Aniorte, Ana Isabel
Vicente‐Ibarra, Nuria
Pernias‐Escrig, Vicente
Carrillo‐Alemán, Luna
Candela‐Sánchez, Elena
Hortelano, Ignacio
Villamía, Beatriz
Sandín‐Rollán, Miriam
Nuñez‐Martínez, Laura
Valdés, Mariano
Marín, Francisco
author_facet Rivera‐Caravaca, José Miguel
Ruiz‐Nodar, Juan Miguel
Tello‐Montoliu, Antonio
Esteve‐Pastor, María Asunción
Quintana‐Giner, Miriam
Véliz‐Martínez, Andrea
Orenes‐Piñero, Esteban
Romero‐Aniorte, Ana Isabel
Vicente‐Ibarra, Nuria
Pernias‐Escrig, Vicente
Carrillo‐Alemán, Luna
Candela‐Sánchez, Elena
Hortelano, Ignacio
Villamía, Beatriz
Sandín‐Rollán, Miriam
Nuñez‐Martínez, Laura
Valdés, Mariano
Marín, Francisco
author_sort Rivera‐Caravaca, José Miguel
collection PubMed
description BACKGROUND: A simple method to assess renal function is the estimated glomerular filtration rate, and it shows prognostic implications. However, it remains unknown which equation should be used in patients with acute coronary syndrome. We compared the ability and correlation of the Cockcroft‐Gault, Modification of Diet in Renal Disease‐4 (MDRD‐4), and Chronic Kidney Disease Epidemiology Collaboration (CKD‐EPI) equations and their predictive performance for major adverse cardiovascular events, all‐cause mortality, and major bleeding in a cohort of patients with acute coronary syndrome. METHODS AND RESULTS: Multicenter prospective registry involving 1699 consecutive patients with acute coronary syndrome from 3 tertiary institutions. At entry, renal function was assessed using the Cockcroft‐Gault, MDRD‐4, and CKD‐EPI‐creatinine equations. During 12 months of follow‐up, we recorded all major adverse cardiovascular events (composite of cardiovascular death, nonfatal myocardial infarction, and nonfatal ischemic stroke), bleeding events (Bleeding Academic Research Consortium classification), and all‐cause mortality. Receiver operating characteristic curve comparisons demonstrated that Cockcroft‐Gault equation had higher predictive ability compared with MDRD‐4 equation for major adverse cardiovascular events (0.651 versus 0.616; P=0.023), major bleeding (0.600 versus 0.551; P=0.005), and all‐cause mortality (0.754 versus 0.717; P=0.033), as well as higher predictive ability compared with CKD‐EPI equation for major bleeding (0.600 versus 0.564; P=0.018). Integrated discrimination improvement and net reclassification improvement analyses showed superior discrimination and reclassification of Cockcroft‐Gault equation. Decision curve analyses graphically demonstrated higher net benefit and clinical usefulness of the Cockcroft‐Gault equation in comparison with MDRD‐4 and CKD‐EPI equations. CONCLUSIONS: In patients with acute coronary syndrome, the Cockcroft‐Gault equation presented superior predictive ability for major adverse cardiovascular events, major bleeding, and all‐cause mortality compared with MDRD‐4 equation, and superior predictive ability for major bleeding compared with CKD‐EPI equation. The Cockcroft‐Gault equation also showed higher net benefit and clinical usefulness.
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spelling pubmed-60152752018-07-05 Disparities in the Estimation of Glomerular Filtration Rate According to Cockcroft‐Gault, Modification of Diet in Renal Disease‐4, and Chronic Kidney Disease Epidemiology Collaboration Equations and Relation With Outcomes in Patients With Acute Coronary Syndrome Rivera‐Caravaca, José Miguel Ruiz‐Nodar, Juan Miguel Tello‐Montoliu, Antonio Esteve‐Pastor, María Asunción Quintana‐Giner, Miriam Véliz‐Martínez, Andrea Orenes‐Piñero, Esteban Romero‐Aniorte, Ana Isabel Vicente‐Ibarra, Nuria Pernias‐Escrig, Vicente Carrillo‐Alemán, Luna Candela‐Sánchez, Elena Hortelano, Ignacio Villamía, Beatriz Sandín‐Rollán, Miriam Nuñez‐Martínez, Laura Valdés, Mariano Marín, Francisco J Am Heart Assoc Original Research BACKGROUND: A simple method to assess renal function is the estimated glomerular filtration rate, and it shows prognostic implications. However, it remains unknown which equation should be used in patients with acute coronary syndrome. We compared the ability and correlation of the Cockcroft‐Gault, Modification of Diet in Renal Disease‐4 (MDRD‐4), and Chronic Kidney Disease Epidemiology Collaboration (CKD‐EPI) equations and their predictive performance for major adverse cardiovascular events, all‐cause mortality, and major bleeding in a cohort of patients with acute coronary syndrome. METHODS AND RESULTS: Multicenter prospective registry involving 1699 consecutive patients with acute coronary syndrome from 3 tertiary institutions. At entry, renal function was assessed using the Cockcroft‐Gault, MDRD‐4, and CKD‐EPI‐creatinine equations. During 12 months of follow‐up, we recorded all major adverse cardiovascular events (composite of cardiovascular death, nonfatal myocardial infarction, and nonfatal ischemic stroke), bleeding events (Bleeding Academic Research Consortium classification), and all‐cause mortality. Receiver operating characteristic curve comparisons demonstrated that Cockcroft‐Gault equation had higher predictive ability compared with MDRD‐4 equation for major adverse cardiovascular events (0.651 versus 0.616; P=0.023), major bleeding (0.600 versus 0.551; P=0.005), and all‐cause mortality (0.754 versus 0.717; P=0.033), as well as higher predictive ability compared with CKD‐EPI equation for major bleeding (0.600 versus 0.564; P=0.018). Integrated discrimination improvement and net reclassification improvement analyses showed superior discrimination and reclassification of Cockcroft‐Gault equation. Decision curve analyses graphically demonstrated higher net benefit and clinical usefulness of the Cockcroft‐Gault equation in comparison with MDRD‐4 and CKD‐EPI equations. CONCLUSIONS: In patients with acute coronary syndrome, the Cockcroft‐Gault equation presented superior predictive ability for major adverse cardiovascular events, major bleeding, and all‐cause mortality compared with MDRD‐4 equation, and superior predictive ability for major bleeding compared with CKD‐EPI equation. The Cockcroft‐Gault equation also showed higher net benefit and clinical usefulness. John Wiley and Sons Inc. 2018-04-21 /pmc/articles/PMC6015275/ /pubmed/29680822 http://dx.doi.org/10.1161/JAHA.118.008725 Text en © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Research
Rivera‐Caravaca, José Miguel
Ruiz‐Nodar, Juan Miguel
Tello‐Montoliu, Antonio
Esteve‐Pastor, María Asunción
Quintana‐Giner, Miriam
Véliz‐Martínez, Andrea
Orenes‐Piñero, Esteban
Romero‐Aniorte, Ana Isabel
Vicente‐Ibarra, Nuria
Pernias‐Escrig, Vicente
Carrillo‐Alemán, Luna
Candela‐Sánchez, Elena
Hortelano, Ignacio
Villamía, Beatriz
Sandín‐Rollán, Miriam
Nuñez‐Martínez, Laura
Valdés, Mariano
Marín, Francisco
Disparities in the Estimation of Glomerular Filtration Rate According to Cockcroft‐Gault, Modification of Diet in Renal Disease‐4, and Chronic Kidney Disease Epidemiology Collaboration Equations and Relation With Outcomes in Patients With Acute Coronary Syndrome
title Disparities in the Estimation of Glomerular Filtration Rate According to Cockcroft‐Gault, Modification of Diet in Renal Disease‐4, and Chronic Kidney Disease Epidemiology Collaboration Equations and Relation With Outcomes in Patients With Acute Coronary Syndrome
title_full Disparities in the Estimation of Glomerular Filtration Rate According to Cockcroft‐Gault, Modification of Diet in Renal Disease‐4, and Chronic Kidney Disease Epidemiology Collaboration Equations and Relation With Outcomes in Patients With Acute Coronary Syndrome
title_fullStr Disparities in the Estimation of Glomerular Filtration Rate According to Cockcroft‐Gault, Modification of Diet in Renal Disease‐4, and Chronic Kidney Disease Epidemiology Collaboration Equations and Relation With Outcomes in Patients With Acute Coronary Syndrome
title_full_unstemmed Disparities in the Estimation of Glomerular Filtration Rate According to Cockcroft‐Gault, Modification of Diet in Renal Disease‐4, and Chronic Kidney Disease Epidemiology Collaboration Equations and Relation With Outcomes in Patients With Acute Coronary Syndrome
title_short Disparities in the Estimation of Glomerular Filtration Rate According to Cockcroft‐Gault, Modification of Diet in Renal Disease‐4, and Chronic Kidney Disease Epidemiology Collaboration Equations and Relation With Outcomes in Patients With Acute Coronary Syndrome
title_sort disparities in the estimation of glomerular filtration rate according to cockcroft‐gault, modification of diet in renal disease‐4, and chronic kidney disease epidemiology collaboration equations and relation with outcomes in patients with acute coronary syndrome
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6015275/
https://www.ncbi.nlm.nih.gov/pubmed/29680822
http://dx.doi.org/10.1161/JAHA.118.008725
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