Key result
Mild-to-severe eGFR decline is linked to ~25% greater incident CHD risk versus normal eGFR.
Why the study?
Epidemiological evidence on the associations of eGFR and BUN with incident coronary heart disease in the Chinese population was limited.
Does a decline in eGFR or elevated BUN increase the risk of incident CHD in middle-aged and elderly Chinese populations?
Cohort (n=16,989)
No
Does a decline in eGFR or elevated BUN increase the risk of incident CHD in middle-aged and elderly Chinese populations?
Hazard Ratio: 1.25 (95% CI 1.05–1.48)
Absolute Event Rate: 17.6% vs 7.2%
p-value: p=0.011
A mild-to-severe decline in eGFR or a raised level of BUN is associated with an increased risk of incident CHD in middle-aged and elderly Chinese populations.
eGFR decline was associated with higher CHD risk in Chinese adults; leaves open causality and utility for risk stratification.
Estimated glomerular filtration rate (eGFR) has been reported to be associated with risk of incident coronary heart disease (CHD), and blood urea nitrogen (BUN) has been shown to be a strong predictor of mortality in patients with heart failure (HF). However, such epidemiological evidence from Chinese population was still limited. We used Cox proportional-hazards regression models to investigate the associations of eGFR and BUN with risk of incident CHD in the prospective Dongfeng-Tongji (DFTJ) cohort. After fully adjusted for potential confounders, a 10-unit decline in eGFR was associated with higher risk for CHD (hazard ratio [HR] 1.05, 95% confidence interval [CI] 1.01–1.09); compared with individuals with normal eGFR levels (eGFR ≥ 90 ml/min per 1.73 m2), individuals with a mild-to-severe eGFR decline (15 to 60 ml/min per 1.73 m2) were at significantly greater risk for CHD (HR 1.25, 95% CI 1.05–1.48; P = 0.011). Compared with individuals in the lowest tertile of BUN, those in the highest tertile were at significantly greater risk for CHD (HR 1.17, 95% CI 1.03–1.33; P = 0.014). In conclusion, a mild-to-severe decline in eGFR or a raised level of BUN might be associated with increased risk of incident CHD in middle-aged and elderly Chinese populations.
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Jiang et al. (2017) conducted a cohort in Incident coronary heart disease (n=16,989). Mild-to-severe eGFR decline (15 to 60 ml/min per 1.73 m2) vs. Normal eGFR (≥ 90 ml/min per 1.73 m2) was evaluated on Incident coronary heart disease (HR 1.25, 95% CI 1.05-1.48, p=0.011). Compared with individuals with normal eGFR levels, those with a mild-to-severe eGFR decline were at significantly greater risk for incident coronary heart disease (HR 1.25).
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