Renal function and risk of coronary heart disease in general populations: new prospective study and systematic review.

<h4>Background</h4>End-stage chronic kidney disease is associated with striking excesses of cardiovascular mortality, but it is uncertain to what extent renal function is related to risk of subsequent coronary heart disease (CHD) in apparently healthy adults. This study aims to quantify...

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Main Authors: Emanuele Di Angelantonio, John Danesh, Gudny Eiriksdottir, Vilmundur Gudnason
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2007-09-01
Series:PLoS Medicine
Online Access:https://journals.plos.org/plosmedicine/article/file?id=10.1371/journal.pmed.0040270&type=printable
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author Emanuele Di Angelantonio
John Danesh
Gudny Eiriksdottir
Vilmundur Gudnason
author_facet Emanuele Di Angelantonio
John Danesh
Gudny Eiriksdottir
Vilmundur Gudnason
author_sort Emanuele Di Angelantonio
collection DOAJ
description <h4>Background</h4>End-stage chronic kidney disease is associated with striking excesses of cardiovascular mortality, but it is uncertain to what extent renal function is related to risk of subsequent coronary heart disease (CHD) in apparently healthy adults. This study aims to quantify the association of markers of renal function with CHD risk in essentially general populations.<h4>Methods and findings</h4>Estimated glomerular filtration rate (eGFR) was calculated using standard prediction equations based on serum creatinine measurements made in 2,007 patients diagnosed with nonfatal myocardial infarction or coronary death during follow-up and in 3,869 people without CHD in the Reykjavik population-based cohort of 18,569 individuals. There were small and nonsignificant odds ratios (ORs) for CHD risk over most of the range in eGFR, except in the lowest category of the lowest fifth (corresponding to values of <60 ml/min/1.73 m2), in which the OR was 1.33 (95% confidence interval 1.01-1.75) after adjustment for several established cardiovascular risk factors. Findings from the Reykjavik study were reinforced by a meta-analysis of six previous reports (identified in electronic and other databases) involving a total of 4,720 incident CHD cases (including Reykjavik), which yielded a combined risk ratio of 1.41 (95% confidence interval 1.19-1.68) in individuals with baseline eGFR less than 60 ml/min/1.73 m2 compared with those with higher values.<h4>Conclusions</h4>Although there are no strong associations between lower-than-average eGFR and CHD risk in apparently healthy adults over most of the range in renal function, there may be a moderate increase in CHD risk associated with very low eGFR (i.e., renal dysfunction) in the general population. These findings could have implications for the further understanding of CHD and targeting cardioprotective interventions.
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spelling doaj-art-eb73eb5fc7d040a88017916566e656cc2025-08-20T03:23:11ZengPublic Library of Science (PLoS)PLoS Medicine1549-12771549-16762007-09-0149e27010.1371/journal.pmed.0040270Renal function and risk of coronary heart disease in general populations: new prospective study and systematic review.Emanuele Di AngelantonioJohn DaneshGudny EiriksdottirVilmundur Gudnason<h4>Background</h4>End-stage chronic kidney disease is associated with striking excesses of cardiovascular mortality, but it is uncertain to what extent renal function is related to risk of subsequent coronary heart disease (CHD) in apparently healthy adults. This study aims to quantify the association of markers of renal function with CHD risk in essentially general populations.<h4>Methods and findings</h4>Estimated glomerular filtration rate (eGFR) was calculated using standard prediction equations based on serum creatinine measurements made in 2,007 patients diagnosed with nonfatal myocardial infarction or coronary death during follow-up and in 3,869 people without CHD in the Reykjavik population-based cohort of 18,569 individuals. There were small and nonsignificant odds ratios (ORs) for CHD risk over most of the range in eGFR, except in the lowest category of the lowest fifth (corresponding to values of <60 ml/min/1.73 m2), in which the OR was 1.33 (95% confidence interval 1.01-1.75) after adjustment for several established cardiovascular risk factors. Findings from the Reykjavik study were reinforced by a meta-analysis of six previous reports (identified in electronic and other databases) involving a total of 4,720 incident CHD cases (including Reykjavik), which yielded a combined risk ratio of 1.41 (95% confidence interval 1.19-1.68) in individuals with baseline eGFR less than 60 ml/min/1.73 m2 compared with those with higher values.<h4>Conclusions</h4>Although there are no strong associations between lower-than-average eGFR and CHD risk in apparently healthy adults over most of the range in renal function, there may be a moderate increase in CHD risk associated with very low eGFR (i.e., renal dysfunction) in the general population. These findings could have implications for the further understanding of CHD and targeting cardioprotective interventions.https://journals.plos.org/plosmedicine/article/file?id=10.1371/journal.pmed.0040270&type=printable
spellingShingle Emanuele Di Angelantonio
John Danesh
Gudny Eiriksdottir
Vilmundur Gudnason
Renal function and risk of coronary heart disease in general populations: new prospective study and systematic review.
PLoS Medicine
title Renal function and risk of coronary heart disease in general populations: new prospective study and systematic review.
title_full Renal function and risk of coronary heart disease in general populations: new prospective study and systematic review.
title_fullStr Renal function and risk of coronary heart disease in general populations: new prospective study and systematic review.
title_full_unstemmed Renal function and risk of coronary heart disease in general populations: new prospective study and systematic review.
title_short Renal function and risk of coronary heart disease in general populations: new prospective study and systematic review.
title_sort renal function and risk of coronary heart disease in general populations new prospective study and systematic review
url https://journals.plos.org/plosmedicine/article/file?id=10.1371/journal.pmed.0040270&type=printable
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AT gudnyeiriksdottir renalfunctionandriskofcoronaryheartdiseaseingeneralpopulationsnewprospectivestudyandsystematicreview
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