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Predicting outcomes after myocardial infarction by using the Chronic Kidney Disease Epidemiology Collaboration equation in comparison with the Modification of Diet in Renal Disease study equation: results from the Korea Acute Myocardial Infarction Registry

Choi, J.S.; Kim, C.S.; Bae, E.H.; Ma, S.K.; Ahn, Y.-K.; Jeong, M.H.; Kim, Y.J.; Cho, M.C.; Kim, C.J.; Kim, S.W.; Jeong, M.H.; Ahn, Y.K.; Chae, S.C.; Kim, J.H.; Hur, S.H.; Kim, Y.J.; Seong, W.; Choi, D.H.; Chae, J.K.; Hong, T.J.; Rhew, J.Y.; Kim, D.I.; Chae, H.; Yoon, J.H.; Koo, K.; Kim, B.O.; Lee, M.Y.; Kim, K.S.; Hwang, J.Y.; Cho, M.C.; Kyu, S.; Lee, N.H.; Jeong, K.T.; Tahk, S.J.; Bae, J.H.; Rha, S.W.; Park, K.S.; Kim, C.J.; Han, K.R.; Ahn, T.H.; Kim, M.H.; Seung, K.B.; Chung, W.S.; Yang, J.Y.;

Nephrology Dialysis Transplantation: Official Publication of the European Dialysis and Transplant Association - European Renal Association 27(10): 3868-3874

2012


ISSN/ISBN: 1460-2385
PMID: 22879394
DOI: 10.1093/ndt/gfs344
Accession: 055099977

The presence of chronic kidney disease is an independent prognostic factor in patients with myocardial infarction (MI). We compared the Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equation and the Modification of Diet in Renal Disease (MDRD) study equation with regard to prognostic value in patients with MI. This study analyzed a retrospective cohort of 11 050 consecutive patients who had MI and were enrolled in the Korea Acute Myocardial Infarction Registry from November 2005 to August 2008. We applied the CKD-EPI equation and the MDRD study equation to determine the estimated glomerular filtration rate (eGFR) in a cohort of patients with MI. The mean eGFR(CKD-EPI) was slightly higher than that of eGFR(MDRD) (73.16 versus 72.23 mL/min/1.73 m(2); P < 0.001). The prevalence of eGFR(CKD-EPI) <60 mL/min/1.73 m(2) was 26.9%, whereas that of eGFR(MDRD) was 28.5%. The area under the receiver operating characteristic curve was significantly larger for predicting the 1-year major adverse cardiovascular event (MACE) and 1-year all-cause mortality with CKD-EPI equation (0.648 versus 0.641, 0.768 versus 0.753, respectively; P < 0.001). The net reclassification index for improvement in risk of 1-year MACE and 1-year all-cause mortality were 4.09% (P< 0.001) and 9.25% (P< 0.001), respectively. The application of the eGFR(CKD-EPI) demonstrated better predictive values for clinical outcomes than eGFR(MDRD) in a cohort of patients with MI.

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