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Risk for recurrent coronary heart disease and all-cause mortality among individuals with chronic kidney disease compared with diabetes mellitus, metabolic syndrome, and cigarette smokers

Background Lipid-lowering guidelines endorse a low-density lipoprotein cholesterol goal of

Journal Title: The American heart journal 2013, Vol.166 (2), p.373-380.e2
Main Author: Baber, Usman, MD, MS
Other Authors: Gutierrez, Orlando M., MD , Levitan, Emily B., PhD , Warnock, David G., MD , Farkouh, Michael E., MD , Tonelli, Marcello, MD , Safford, Monika M., MD , Muntner, Paul, PhD
Format: Electronic Article Electronic Article
Language: English
Subjects:
Abridged Index Medicus
Aged
Article
Cardiovascular
Cardiovascular disease
Cholesterol
Chronic kidney failure
Cigarettes
Coronary Artery Disease - etiology
Coronary heart disease
Diabetes Mellitus
Drug therapy
Female
Health aspects
Heart attacks
Humans
Incidence
Low density lipoproteins
Male
Metabolic syndrome
Metabolic Syndrome - complications
Middle Aged
Mortality
Older people
Recurrence
Renal Insufficiency, Chronic - complications
Risk Factors
Smoking
Smoking - adverse effects
Quelle: Alma/SFX Local Collection
Publisher: United States: Mosby, Inc
ID: ISSN: 0002-8703
Link: https://www.ncbi.nlm.nih.gov/pubmed/23895822
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title: Risk for recurrent coronary heart disease and all-cause mortality among individuals with chronic kidney disease compared with diabetes mellitus, metabolic syndrome, and cigarette smokers
format: Article
creator:
  • Baber, Usman, MD, MS
  • Gutierrez, Orlando M., MD
  • Levitan, Emily B., PhD
  • Warnock, David G., MD
  • Farkouh, Michael E., MD
  • Tonelli, Marcello, MD
  • Safford, Monika M., MD
  • Muntner, Paul, PhD
subjects:
  • Abridged Index Medicus
  • Aged
  • Article
  • Cardiovascular
  • Cardiovascular disease
  • Cholesterol
  • Chronic kidney failure
  • Cigarettes
  • Coronary Artery Disease - etiology
  • Coronary heart disease
  • Diabetes Mellitus
  • Drug therapy
  • Female
  • Health aspects
  • Heart attacks
  • Humans
  • Incidence
  • Low density lipoproteins
  • Male
  • Metabolic syndrome
  • Metabolic Syndrome - complications
  • Middle Aged
  • Mortality
  • Older people
  • Recurrence
  • Renal Insufficiency, Chronic - complications
  • Risk Factors
  • Smoking
  • Smoking - adverse effects
ispartof: The American heart journal, 2013, Vol.166 (2), p.373-380.e2
description: Background Lipid-lowering guidelines endorse a low-density lipoprotein cholesterol goal of
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0002-8703
fulltext: fulltext
issn:
  • 0002-8703
  • 1097-6744
url: Link


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titleRisk for recurrent coronary heart disease and all-cause mortality among individuals with chronic kidney disease compared with diabetes mellitus, metabolic syndrome, and cigarette smokers
sourceAlma/SFX Local Collection
creatorBaber, Usman, MD, MS ; Gutierrez, Orlando M., MD ; Levitan, Emily B., PhD ; Warnock, David G., MD ; Farkouh, Michael E., MD ; Tonelli, Marcello, MD ; Safford, Monika M., MD ; Muntner, Paul, PhD
creatorcontribBaber, Usman, MD, MS ; Gutierrez, Orlando M., MD ; Levitan, Emily B., PhD ; Warnock, David G., MD ; Farkouh, Michael E., MD ; Tonelli, Marcello, MD ; Safford, Monika M., MD ; Muntner, Paul, PhD
descriptionBackground Lipid-lowering guidelines endorse a low-density lipoprotein cholesterol goal of <100 mg/dL for people with coronary heart disease (CHD). A more stringent threshold of <70 mg/dL is recommended for those with CHD and “very high-risk” conditions such as diabetes mellitus, metabolic syndrome, or cigarette smoking. Whether chronic kidney disease (CKD) confers a similar risk for recurrent CHD events is unknown. Methods and Results We evaluated the risk for recurrent CHD events and all-cause mortality among 3,938 participants ≥45 years with CHD in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. Chronic kidney disease was defined by estimated glomerular filtration rate <60 mL/min per 1.73 m2 or urinary albumin to creatinine ratio ≥30 mg/g. Participants were categorized by the presence or absence of CKD and any very high-risk condition. Over a median of 4.1 years, the crude incidence (95% CI) of recurrent CHD events were 12.1 (9.0-15.2), 18.9 (15.5-22.3), 35.0 (25.4-44.6), and 34.2 (28.2-40.3) among those without CKD or high-risk conditions; very high-risk conditions alone; and CKD alone and both CKD and very high-risk conditions. After multivariable adjustment, compared with those without CKD or very high-risk conditions, the hazard ratio (95% CI) for recurrent CHD events was 1.45 (1.02-2.05), 2.24 (1.50-3.34), and 2.10 (1.47-2.98) among those with very high-risk conditions alone, CKD alone, and both CKD and very high-risk conditions, respectively. Results were consistent for all-cause mortality. Conclusions Chronic kidney disease is associated with risk for recurrent CHD events that approximates or is larger than other established very high-risk conditions.
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1EISSN: 1097-6744
2DOI: 10.1016/j.ahj.2013.05.008
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languageeng
publisherUnited States: Mosby, Inc
subjectAbridged Index Medicus ; Aged ; Article ; Cardiovascular ; Cardiovascular disease ; Cholesterol ; Chronic kidney failure ; Cigarettes ; Coronary Artery Disease - etiology ; Coronary heart disease ; Diabetes Mellitus ; Drug therapy ; Female ; Health aspects ; Heart attacks ; Humans ; Incidence ; Low density lipoproteins ; Male ; Metabolic syndrome ; Metabolic Syndrome - complications ; Middle Aged ; Mortality ; Older people ; Recurrence ; Renal Insufficiency, Chronic - complications ; Risk Factors ; Smoking ; Smoking - adverse effects
ispartofThe American heart journal, 2013, Vol.166 (2), p.373-380.e2
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1Gutierrez, Orlando M., MD
2Levitan, Emily B., PhD
3Warnock, David G., MD
4Farkouh, Michael E., MD
5Tonelli, Marcello, MD
6Safford, Monika M., MD
7Muntner, Paul, PhD
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descriptionBackground Lipid-lowering guidelines endorse a low-density lipoprotein cholesterol goal of <100 mg/dL for people with coronary heart disease (CHD). A more stringent threshold of <70 mg/dL is recommended for those with CHD and “very high-risk” conditions such as diabetes mellitus, metabolic syndrome, or cigarette smoking. Whether chronic kidney disease (CKD) confers a similar risk for recurrent CHD events is unknown. Methods and Results We evaluated the risk for recurrent CHD events and all-cause mortality among 3,938 participants ≥45 years with CHD in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. Chronic kidney disease was defined by estimated glomerular filtration rate <60 mL/min per 1.73 m2 or urinary albumin to creatinine ratio ≥30 mg/g. Participants were categorized by the presence or absence of CKD and any very high-risk condition. Over a median of 4.1 years, the crude incidence (95% CI) of recurrent CHD events were 12.1 (9.0-15.2), 18.9 (15.5-22.3), 35.0 (25.4-44.6), and 34.2 (28.2-40.3) among those without CKD or high-risk conditions; very high-risk conditions alone; and CKD alone and both CKD and very high-risk conditions. After multivariable adjustment, compared with those without CKD or very high-risk conditions, the hazard ratio (95% CI) for recurrent CHD events was 1.45 (1.02-2.05), 2.24 (1.50-3.34), and 2.10 (1.47-2.98) among those with very high-risk conditions alone, CKD alone, and both CKD and very high-risk conditions, respectively. Results were consistent for all-cause mortality. Conclusions Chronic kidney disease is associated with risk for recurrent CHD events that approximates or is larger than other established very high-risk conditions.
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23Older people
24Recurrence
25Renal Insufficiency, Chronic - complications
26Risk Factors
27Smoking
28Smoking - adverse effects
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titleRisk for recurrent coronary heart disease and all-cause mortality among individuals with chronic kidney disease compared with diabetes mellitus, metabolic syndrome, and cigarette smokers
authorBaber, Usman, MD, MS ; Gutierrez, Orlando M., MD ; Levitan, Emily B., PhD ; Warnock, David G., MD ; Farkouh, Michael E., MD ; Tonelli, Marcello, MD ; Safford, Monika M., MD ; Muntner, Paul, PhD
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9Coronary heart disease
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16Incidence
17Low density lipoproteins
18Male
19Metabolic syndrome
20Metabolic Syndrome - complications
21Middle Aged
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25Renal Insufficiency, Chronic - complications
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0Baber, Usman, MD, MS
1Gutierrez, Orlando M., MD
2Levitan, Emily B., PhD
3Warnock, David G., MD
4Farkouh, Michael E., MD
5Tonelli, Marcello, MD
6Safford, Monika M., MD
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atitleRisk for recurrent coronary heart disease and all-cause mortality among individuals with chronic kidney disease compared with diabetes mellitus, metabolic syndrome, and cigarette smokers
jtitleThe American heart journal
addtitleAm Heart J
date2013
risdate2013
volume166
issue2
spage373
epage380.e2
pages373-380.e2
issn0002-8703
eissn1097-6744
codenAHJOA2
abstractBackground Lipid-lowering guidelines endorse a low-density lipoprotein cholesterol goal of <100 mg/dL for people with coronary heart disease (CHD). A more stringent threshold of <70 mg/dL is recommended for those with CHD and “very high-risk” conditions such as diabetes mellitus, metabolic syndrome, or cigarette smoking. Whether chronic kidney disease (CKD) confers a similar risk for recurrent CHD events is unknown. Methods and Results We evaluated the risk for recurrent CHD events and all-cause mortality among 3,938 participants ≥45 years with CHD in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. Chronic kidney disease was defined by estimated glomerular filtration rate <60 mL/min per 1.73 m2 or urinary albumin to creatinine ratio ≥30 mg/g. Participants were categorized by the presence or absence of CKD and any very high-risk condition. Over a median of 4.1 years, the crude incidence (95% CI) of recurrent CHD events were 12.1 (9.0-15.2), 18.9 (15.5-22.3), 35.0 (25.4-44.6), and 34.2 (28.2-40.3) among those without CKD or high-risk conditions; very high-risk conditions alone; and CKD alone and both CKD and very high-risk conditions. After multivariable adjustment, compared with those without CKD or very high-risk conditions, the hazard ratio (95% CI) for recurrent CHD events was 1.45 (1.02-2.05), 2.24 (1.50-3.34), and 2.10 (1.47-2.98) among those with very high-risk conditions alone, CKD alone, and both CKD and very high-risk conditions, respectively. Results were consistent for all-cause mortality. Conclusions Chronic kidney disease is associated with risk for recurrent CHD events that approximates or is larger than other established very high-risk conditions.
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pmid23895822
doi10.1016/j.ahj.2013.05.008
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