Effect of first myocardial ischemic event on renal function

Am J Cardiol. 2007 Jul 1;100(1):7-12. doi: 10.1016/j.amjcard.2007.02.047. Epub 2007 May 7.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Creatinine / blood
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate
  • Humans
  • Male
  • Middle Aged
  • Myocardial Ischemia / complications*
  • Renal Insufficiency / blood
  • Renal Insufficiency / etiology*
  • Risk Factors

Substances

  • Creatinine