Chronic kidney disease and risk of incident myocardial infarction and all-cause and cardiovascular disease mortality in middle-aged men and women from the general population
Chronic kidney disease and risk of incident myocardial infarction and all-cause and cardiovascular disease mortality in middle-aged men and women from the general population
复制标题
DOI：
10.1093/eurheartj/ehi880
复制
发表时间：
2006-05-01
影响因子：
39.3
通讯作者：
Löwel, H
中科院分区：
文献类型：
--
作者：
Meisinger, C;Döring, A;Löwel, H
目的慢性肾脏疾病（CKD）是高危人群全因死亡率和不良心血管疾病（CVD）事件的独立危险因素。基于人群的研究结果很少且不一致。我们在一个基于人群的队列中研究了CKD与全因死亡率、心血管死亡率和心肌梗死（MI）发生率的性别特异性关联。方法和结果该研究基于3860名男性和3674名女性（年龄在45-74岁），他们参加了1984年至1995年间莫妮卡奥格斯堡三次调查中的一次。CKD的定义是肾小球滤过率在15 - 59 mL/min/1.73 m之间(2)。风险比（hr）由Cox比例风险模型估计。在这项研究中，截至2002年12月31日，共有890人死亡，400人死于心血管疾病，321人死亡；女性的相应数字分别为442、187和102。在多变量分析中，与保留肾功能的女性相比，患有CKD的女性的心肌梗死发生率显著[HR 1.67；95%可信区间（CI） 1.07-2.61)和心血管疾病死亡率（HR 1.60; 95% CI 1.17-2.18）。在男性中，在校正常见心血管疾病危险因素后，CKD也与心肌梗死（HR 1.51; 95% CI 1.09-2.10）和心血管疾病死亡率（HR 1.48; 95% CI 1.15-1.92）显著相关。相比之下，患有慢性肾病的男性和女性的全因死亡率没有明显增加。结论：在普通人群中，CKD与心肌梗死和心血管疾病死亡率增加的风险密切相关，独立于常见的心血管危险因素。
Aims Chronic kidney disease (CKD) was found to be an independent risk factor for all-cause mortality as well as adverse cardiovascular disease (CVD) events in high-risk populations. Findings from population-based studies are scarce and inconsistent. We investigated the gender-specific association of CKD with all-cause mortality, cardiovascular mortality, and incident myocardial infarction (MI) in a population-based cohort.Methods and results The study was based on 3860 men and 3674 women (aged 45-74 years) who participated in one of the three MONICA Augsburg surveys between 1984 and 1995. CKD was defined by an estimated glomerular filtration rate between 15 and 59 mL/min/1.73 m(2). Hazard ratios (HRs) were estimated from Cox proportional hazard models. In this study, 890 total deaths, 400 CVD deaths, and 321 incident MIs occurred in men up to 31 December 2002; the corresponding numbers in women were 442, 187, and 102. In multivariable analyses, the HR for women with CKD compared to women with preserved renal function was significant for incident MI [HR 1.67; 95% confidence interval (CI) 1.07-2.61] and CVD mortality (HR 1.60; 95% CI 1.17-2.18). In men, CKD was also significantly associated with incident MI (HR 1.51; 95% CI 1.09-2.10) and CVD mortality (HR 1.48; 95% CI 1.15-1.92) after adjustment for common CVD risk factors. In contrast, men and women with CKD had no significant increased risk of all-cause mortality.Conclusion CKD was strongly associated with an increased risk of incident MI and CVD mortality independent from common cardiovascular risk factors in men and women from the general population.