Reduced glomerular filtration rate as a predictor of coronary artery disease events in elderly patients

Abstract

Background: Chronic kidney disease is independently associated with cardiovascular disease (CVD) events in high-risk populations according to several studies. However, findings from community-based population studies are insufficient. We studied the relationship between estimated glomerular filtration rate (eGFR) and risk of coronary artery disease (CAD) events in patients attending Zagazig University Hospital, Sharqiya governorate, Egypt.

Methods: A total of 800 subjects aged ≥ 60 years admitted to Internal Medicine Department or attended medicine outpatient clinic were included in this study. Careful history and full clinical examinations were done to assess the risk factors of CAD. Serum creatinine, lipid profile and serum glucose were measured. Estimated eGFR was evaluated by creatinine based MDRD formula. According to eGFR, patients were divided into 2 groups: group 1 with eGFR ≥ 60 mL/min/1.73 m² and Group 2 with eGFR < 60 mL/min/1.73 m (between 40 and 60 mL/min/1.73 m).

Results: 410 patients were found to have eGFR P 60 mL/min/1.73 m², while 390 patients were found to have eGFR < 60 mL/min/1.73 m². eGFR was lower in patients with CAD (62 ± 13 mL/min/1.73 m²) in comparison with patients without CAD (76 ± 11 mL/min/1.73 m²) (P  ≤ 0.001). Older age, hypertension, Diabetes and Low HDL are highly significant risk factors for CAD in those patients (P 0.001).

Conclusions: Reduced eGFR is a significant risk factor for CAD events in older patients. Monitoring of eGFR may have a pivotal role in early detection and management of CAD in those types of patients.

Keywords: Coronary artery disease; Glomerular filtration rate; Elderly