[Prognostic value of glomerular filtrate in acute coronary syndrome: Cockcroft's index or MDRD equation?].
OBJECTIVE
One third of patients with a coronary event show kidney failure. Our aim is to establish the relationship between kidney failure and mortality in patients diagnosed of acute coronary syndrome (ACS) through Cockcroft Index (C-G) and MDRD-4 equation, analyzing which of them is better for prognostic stratification.


METHODS
Prospective study of 445 patients admitted consecutively between 2006 and 2007 with a high risk of ACS, dividing the sample depending on his kidney function at admission in < 60 mL/min/1.73 m(2) and > or =60 mL/min/1.73 m(2) through C-G and Modification of Diet in Renal Disease study group 4 (MDRD-4) and other variables. We performed a multivariate logistic regression for both of them, analysing the relationship with mortality in the following six months after admission.


RESULTS
Renal failure was present in 27.9% (creatinine < 1.1mg/dl); 30.5% (C-G) and 22.6% (MDRD-4). Glomerular filtration (GF) was 81.6+/-35.2 mL/min (C-G) and 77.2+/-26.1 mL/min/1.73 m(2) (MDRD-4). Patients with GF < 60 mL/min showed high mortality, Odds ratio 2.652; p=0.024 (IC 95%, 1.140-6.166) for C-G and 3.372; p=0.001 (IC 95%, 1.637-6.954) for MDRD-4.


CONCLUSIONS
Renal failure increases the risk to die in the following six months after an ACS. The estimation through Cockcroft Index and/or MDRD-4 equation depends on the population characteristics and is indifferent with GF between 60 and 80 mL/min.
Cabrerizo García
José Luis
JL
Servicio de Medicina Interna, Hospital Clínico Lozano Bleza, Zaragoza, España. j_cabrerizo@hotmail.com
Zalba Etayo
Begoña
B
Pérez Calvo
Juan I
JI
D054058:Acute Coronary Syndrome / Q000097:blood / Q000401:mortality* / Q000503:physiopathology; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001145:Arrhythmias, Cardiac / Q000453:epidemiology / Q000503:physiopathology; D015897:Comorbidity; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011446:Prospective Studies; D051437:Renal Insufficiency / Q000097:blood / Q000401:mortality* / Q000503:physiopathology; D012307:Risk Factors; D012720:Severity of Illness Index
D003404:Creatinine