Cardiovascular Outcomes and Renal Disease

Letters16 April 2002Cardiovascular Outcomes and Renal DiseasePeter A. McCullough, MD, MPH, Keisha R. Sandberg, BS, and Steven Borzak, MDPeter A. McCullough, MD, MPHUniversity of Missouri–Kansas City School of Medicine; Kansas City, MO 64108 (McCullough)Henry Ford Heart and Vascular Institute; Detroit, MI 48202 (Sandberg, Borzak)Search for more papers by this author, Keisha R. Sandberg, BSUniversity of Missouri–Kansas City School of Medicine; Kansas City, MO 64108 (McCullough)Henry Ford Heart and Vascular Institute; Detroit, MI 48202 (Sandberg, Borzak)Search for more papers by this author, and Steven Borzak, MDUniversity of Missouri–Kansas City School of Medicine; Kansas City, MO 64108 (McCullough)Henry Ford Heart and Vascular Institute; Detroit, MI 48202 (Sandberg, Borzak)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-136-8-200204160-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Mann and coworkers (1) reported on the independent association between baseline renal insufficiency (serum creatinine level, 124 to 200 µmol/L [1.4 to 2.3 mg/dL]) and cardiovascular outcomes in the Heart Outcomes and Prevention Evaluation (HOPE) study. Although the Discussion section of the paper focuses on the pathophysiologic reasoning for why renal insufficiency may accelerate atherosclerosis, the authors have missed the larger picture of “cardiorenal risk” (1).We believe that there are four explanations for poor outcomes in patients with renal insufficiency: 1) excess and incompletely controlled confounding of conventional risk factors, 2) therapeutic nihilism, 3) complications from ...References1. Mann JF, Gerstein HC, Pogue J, Bosch J, Yusuf S. Renal insufficiency as a predictor of cardiovascular outcomes and the impact of ramipril: the HOPE randomized trial. Ann Intern Med. 2001;134:629-36. [PMID: 11304102] LinkGoogle Scholar2. McCullough PA, Soman SS, Shah SS, Smith ST, Marks KR, Yee J, et al . Risks associated with renal dysfunction in patients in the coronary care unit. J Am Coll Cardiol. 2000;36:679-84. [PMID: 10987584] CrossrefMedlineGoogle Scholar3. McCullough PA, Wolyn R, Rocher LL, Levin RN, O'Neill WW. Acute renal failure after coronary intervention: incidence, risk factors, and relationship to mortality. Am J Med. 1997;103:368-75. [PMID: 9375704] CrossrefMedlineGoogle Scholar4. Chertow GM, Lazarus JM, Christiansen CL, Cook EF, Hammermeister KE, Grover F, et al . Preoperative renal risk stratification. Circulation. 1997;95:878-84. [PMID: 9054745] CrossrefMedlineGoogle Scholar5. Beattie JN, Soman SS, Sandberg KR, Yee J, Borzak S, Garg M, et al . Determinants of mortality after myocardial infarction in patients with advanced renal dysfunction. Am J Kidney Dis. 2001;37:1191-200. [PMID: 11382688] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Peter A. McCullough, MD, MPH; Keisha R. Sandberg, BS; Steven Borzak, MDAffiliations: University of Missouri–Kansas City School of Medicine; Kansas City, MO 64108 (McCullough)Henry Ford Heart and Vascular Institute; Detroit, MI 48202 (Sandberg, Borzak) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRenal Insufficiency as a Predictor of Cardiovascular Outcomes and the Impact of Ramipril: The HOPE Randomized Trial Johannes F.E. Mann , Hertzel C. Gerstein , Janice Pogue , Jackie Bosch , Salim Yusuf , and Cardiovascular Outcomes and Renal Disease Johannes F.E. Mann , Hertzel C. Gerstein , and Salim Yusuf Metrics Cited byUltrasound lung comets for the differential diagnosis of acute cardiogenic dyspnoea: A comparison with natriuretic peptides☆Morbidity, mortality and economic burden of renal impairment in cardiac intensive careBivalirudin provides increasing benefit with decreasing renal function: a meta-analysis of randomized trials 16 April 2002Volume 136, Issue 8Page: 633-634KeywordsAtherosclerosisCardiovascular disease riskMedical risk factorsMortalityReasoningRenal diseasesRenal failureSurgeryTouchValvular diseases ePublished: 16 April 2002 Issue Published: 16 April 2002 Copyright & PermissionsCopyright © 2002 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...