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Influence of age on the effect of reduced renal function on outcomes in patients with coronary artery disease
BACKGROUND: Ageing is a risk factor for both coronary artery disease (CAD) and reduced renal function (RRF), and it is also associated with poor prognosis in patients with CAD or RRF. However, little is known about whether the impact of RRF on clinical outcomes are different in CAD patients at diffe...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6380002/ https://www.ncbi.nlm.nih.gov/pubmed/30777040 http://dx.doi.org/10.1186/s12889-019-6498-6 |
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author | Chen, Fei Zuo, Zhi-liang Huang, Fang-yang Xia, Tian-li Huang, Bao-tao Chai, Hua Li, Qiao Pu, Xiao-bo Gui, Yi-yue Peng, Yong Chen, Mao Huang, De-jia |
author_facet | Chen, Fei Zuo, Zhi-liang Huang, Fang-yang Xia, Tian-li Huang, Bao-tao Chai, Hua Li, Qiao Pu, Xiao-bo Gui, Yi-yue Peng, Yong Chen, Mao Huang, De-jia |
author_sort | Chen, Fei |
collection | PubMed |
description | BACKGROUND: Ageing is a risk factor for both coronary artery disease (CAD) and reduced renal function (RRF), and it is also associated with poor prognosis in patients with CAD or RRF. However, little is known about whether the impact of RRF on clinical outcomes are different in CAD patients at different age groups. This study aimed to investigate whether ageing influences the effect of RRF on long-term risk of death in patients with CAD. METHODS: A retrospective analysis was conducted using data from a single-center cohort study. Three thousand and two consecutive patients with CAD confirmed by coronary angiography were enrolled. RRF was defined as an estimated glomerular filtration rate (eGFR) of less than 60 ml/min. The primary endpoint in this study was all-cause mortality. RESULTS: The mean follow-up time was 29.1 ± 12.5 months and death events occurred in 275 cases (all-cause mortality: 9.2%). The correlation analysis revealed a negative correlation between eGFR and age (r = − 0.386, P < 0.001). Comparing the younger group (age ≤ 59) with the elderly one (age ≥ 70), the prevalence of RRF increased from 5.9 to 27.5%. Multivariable Cox regression revealed that RRF was independently associated with all-cause mortality in all age groups, and the relative risks in older patients were lower than those in younger ones (age ≤ 59 vs. age 60–69 vs. age ≥ 70: hazard ratio [HR] 2.57, 95% confidence interval [CI] 1.04–6.37 vs. HR 2.00, 95% CI 1.17–3.42 vs. HR 1.46, 95% CI 1.06–2.02). There was a significant trend for HRs for all-cause mortality according to the interaction terms for RRF and age group (RRF*age [≤59] vs. RRF*age [60–69] vs. RRF*age [≥70]: HR 1.00[reference] vs. HR 0.60, 95% CI 0.23–1.54 vs. HR 0.32, 95% CI 0.14–0.75; P for trend = 0.010). CONCLUSIONS: RRF may have different impacts on clinical outcomes in CAD patients at different age groups. The association of RRF with the risk of all-cause mortality was attenuated with ageing. |
format | Online Article Text |
id | pubmed-6380002 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-63800022019-02-28 Influence of age on the effect of reduced renal function on outcomes in patients with coronary artery disease Chen, Fei Zuo, Zhi-liang Huang, Fang-yang Xia, Tian-li Huang, Bao-tao Chai, Hua Li, Qiao Pu, Xiao-bo Gui, Yi-yue Peng, Yong Chen, Mao Huang, De-jia BMC Public Health Research Article BACKGROUND: Ageing is a risk factor for both coronary artery disease (CAD) and reduced renal function (RRF), and it is also associated with poor prognosis in patients with CAD or RRF. However, little is known about whether the impact of RRF on clinical outcomes are different in CAD patients at different age groups. This study aimed to investigate whether ageing influences the effect of RRF on long-term risk of death in patients with CAD. METHODS: A retrospective analysis was conducted using data from a single-center cohort study. Three thousand and two consecutive patients with CAD confirmed by coronary angiography were enrolled. RRF was defined as an estimated glomerular filtration rate (eGFR) of less than 60 ml/min. The primary endpoint in this study was all-cause mortality. RESULTS: The mean follow-up time was 29.1 ± 12.5 months and death events occurred in 275 cases (all-cause mortality: 9.2%). The correlation analysis revealed a negative correlation between eGFR and age (r = − 0.386, P < 0.001). Comparing the younger group (age ≤ 59) with the elderly one (age ≥ 70), the prevalence of RRF increased from 5.9 to 27.5%. Multivariable Cox regression revealed that RRF was independently associated with all-cause mortality in all age groups, and the relative risks in older patients were lower than those in younger ones (age ≤ 59 vs. age 60–69 vs. age ≥ 70: hazard ratio [HR] 2.57, 95% confidence interval [CI] 1.04–6.37 vs. HR 2.00, 95% CI 1.17–3.42 vs. HR 1.46, 95% CI 1.06–2.02). There was a significant trend for HRs for all-cause mortality according to the interaction terms for RRF and age group (RRF*age [≤59] vs. RRF*age [60–69] vs. RRF*age [≥70]: HR 1.00[reference] vs. HR 0.60, 95% CI 0.23–1.54 vs. HR 0.32, 95% CI 0.14–0.75; P for trend = 0.010). CONCLUSIONS: RRF may have different impacts on clinical outcomes in CAD patients at different age groups. The association of RRF with the risk of all-cause mortality was attenuated with ageing. BioMed Central 2019-02-18 /pmc/articles/PMC6380002/ /pubmed/30777040 http://dx.doi.org/10.1186/s12889-019-6498-6 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Chen, Fei Zuo, Zhi-liang Huang, Fang-yang Xia, Tian-li Huang, Bao-tao Chai, Hua Li, Qiao Pu, Xiao-bo Gui, Yi-yue Peng, Yong Chen, Mao Huang, De-jia Influence of age on the effect of reduced renal function on outcomes in patients with coronary artery disease |
title | Influence of age on the effect of reduced renal function on outcomes in patients with coronary artery disease |
title_full | Influence of age on the effect of reduced renal function on outcomes in patients with coronary artery disease |
title_fullStr | Influence of age on the effect of reduced renal function on outcomes in patients with coronary artery disease |
title_full_unstemmed | Influence of age on the effect of reduced renal function on outcomes in patients with coronary artery disease |
title_short | Influence of age on the effect of reduced renal function on outcomes in patients with coronary artery disease |
title_sort | influence of age on the effect of reduced renal function on outcomes in patients with coronary artery disease |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6380002/ https://www.ncbi.nlm.nih.gov/pubmed/30777040 http://dx.doi.org/10.1186/s12889-019-6498-6 |
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