Effect of first myocardial ischemic event on renal function.
Effects of cardiovascular dysfunction on renal function have been poorly characterized. Therefore, we investigated the relation between a first ischemic cardiac event and long-term renal function changes in the general population from the PREVEND study. We studied 6,360 subjects with a total follow-up duration of 27.017 subject-years. The estimated mean proportional increase in serum creatinine after a first ischemic cardiac event was 3.1% compared with 0.4% per year of follow-up in subjects without such an event (p = 0.005). This represented a significantly larger decrease in estimated glomerular filtration rate after the event in subjects with an event versus the decrease in subjects without a first ischemic cardiac event (2.2 vs 0.5 ml/min/1.73 m(2)/year of follow-up, p = 0.006). In multivariate analysis with adjustment for renal risk factors, this event showed an independent association with serum creatinine change. In conclusion, a first ischemic cardiac event appears to enhance the natural decrease in renal function. Because even mild renal dysfunction should be considered a major cardiovascular risk factor after myocardial infarction, increased renal function loss after an ischemic cardiac event could add to the risk for subsequent cardiovascular morbidity, thus closing a vicious circle.
Eijkelkamp
Wouter B A
WB
Department of Clinical Pharmacology, Division of Nephrology, University Medical Center Groningen, Groningen, The Netherlands. eijkelkamp@cs.com
de Graeff
Pieter A
PA
van Veldhuisen
Dirk J
DJ
van Dokkum
Richard P E
RP
Gansevoort
Ronald T
RT
de Jong
Paul E
PE
de Zeeuw
Dick
D
Hillege
Hans L
HL
D000328:Adult; D000368:Aged; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications*; D051437:Renal Insufficiency / Q000097:blood / Q000209:etiology*; D012307:Risk Factors
D003404:Creatinine