Renal function and risk stratification of diabetic and nondiabetic patients undergoing evaluation for coronary artery disease

JACC. Cardiovascular Imaging
Abdul HakeemSu Min Chang

Abstract

The aim of this study was to evaluate the impact of renal function by estimated glomerular filtration rate (eGFR) on risk stratification of diabetic and nondiabetic patients undergoing myocardial perfusion imaging (MPI) by single-photon emission computed tomography for suspected ischemia. Coronary artery disease is the leading cause of death among diabetic persons; however, diabetic persons are a very heterogeneous group in terms of cardiovascular risk, necessitating further risk stratification. Patients (n = 1,747, age 65 +/- 10 years, 37% diabetic) undergoing MPI were followed for cardiac death (CD) for a mean of 2.15 +/- 0.8 years. Chronic kidney disease (CKD) was defined by an eGFR <60 ml/min. In the presence of a normal scan, annual CD rate was 0.9% for those with no diabetes mellitus (DM) and no CKD, 0.5% in the DM alone group, 2.35% in CKD alone, and 2.9% in those with both DM and CKD (p < 0.001). Patients with DM+CKD had a 2.7-fold risk of CD compared with no DM no CKD (p = 0.001) after controlling for age, ejection fraction, history of coronary artery disease, and other risk factors. The risk of CD increased as a function of the presence and severity of perfusion defects, regardless of CKD or DM status. Presence of CKD...Continue Reading

References

Oct 11, 2001·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·M G TreuthM S Verani
Feb 15, 2002·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Michael J ZellwegerDaniel S Berman
Feb 22, 2002·Journal of the American Society of Nephrology : JASN·Paul MuntnerPaul K Whelton
Mar 30, 2002·Journal of the American College of Cardiology·Patricia J M BestPeter B Berger
Sep 18, 2002·Kidney International·Ronald M A HenryCoen D A Stehouwer
Feb 7, 2003·Journal of the American College of Cardiology·Guruprasad ManjunathMark J Sarnak
Mar 19, 2003·Seminars in Dialysis·Katrin UhligMark J Sarnak
May 16, 2003·JAMA : the Journal of the American Medical Association·Aram V ChobanianUNKNOWN National High Blood Pressure Education Program Coordinating Committee
Jul 16, 2003·Annals of Internal Medicine·Andrew S LeveyUNKNOWN National Kidney Foundation
Oct 29, 2003·Circulation·Mark J SarnakUNKNOWN American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology,
Feb 6, 2004·Annals of Internal Medicine·Jing ChenJiang He
Apr 22, 2004·Journal of the American Society of Nephrology : JASN·Daniel E WeinerMark J Sarnak
May 12, 2004·Archives of Internal Medicine·Mahboob RahmanUNKNOWN Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial Collaborative Research Group
Jul 28, 2004·Diabetes Care·Frans J Th WackersUNKNOWN Detection of Ischemia in Asymptomatic Diabetics Investigators
Aug 18, 2004·Journal of the American College of Cardiology·Daniel S BermanAlan Rozanski
Sep 24, 2004·The New England Journal of Medicine·Nagesh S AnavekarMarc A Pfeffer
Sep 24, 2004·The New England Journal of Medicine·Alan S GoChi-yuan Hsu
Sep 1, 2005·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Uptal D PatelRodney A Hayward
Jan 3, 2006·Journal of the American College of Cardiology·Roldano ScognamiglioAngelo Avogaro
Aug 16, 2006·Annals of Internal Medicine·Andrew S LeveyUNKNOWN Chronic Kidney Disease Epidemiology Collaboration
Jun 9, 2007·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Sabahat BokhariBenjamin D McCallister
Mar 1, 2008·Diabetes Care·UNKNOWN American Diabetes Association
Apr 16, 2009·JAMA : the Journal of the American Medical Association·Lawrence H YoungUNKNOWN DIAD Investigators

❮ Previous
Next ❯

Citations

Sep 3, 2010·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·George A Beller
Mar 12, 2011·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Abdul HakeemSu Min Chang
Jul 26, 2011·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Fadi G Hage, Ami E Iskandrian
Feb 14, 2012·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·E Gordon DepueyL Samuel Wann
Apr 2, 2011·Future Cardiology·Claude Le FeuvreOlivier Barthelemy
Jul 19, 2014·JACC. Cardiovascular Imaging·Abdul HakeemSu Min Chang
Dec 17, 2011·JACC. Cardiovascular Imaging·Jamieson M Bourque, George A Beller

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antihypertensive Agents: Mechanisms of Action

Antihypertensive drugs are used to treat hypertension (high blood pressure) which aims to prevent the complications of high blood pressure, such as stroke and myocardial infarction. Discover the latest research on antihypertensive drugs and their mechanism of action here.

Cardiovascular Disease Pathophysiology

Cardiovascular disease involves several different processes that contribute to the pathological mechanism, including hyperglycemia, inflammation, atherosclerosis, hypertension and more. Vasculature stability plays a critical role in the development of the disease. Discover the latest research on cardiovascular disease pathophysiology here.

Antianginal Drugs: Mechanisms of Action

Antianginal drugs, including nitrates, beta-blockers, and calcium channel blockers, are used in the treatment of angina pectoris. Here is the latest research on their use and their mechanism of action.