|
Facebook
Twitter
Linkedin
|
 |
 |
 |
 |
Specialities 
Cardiology Renal dysfunction predicts sudden cardiac death in women with heart disease
Cardiology Renal dysfunction predicts sudden cardiac death in women with heart disease
Renal dysfunction predicts sudden cardiac death in women with heart disease
Monday, 29 November 1999 19:00 | 
| Specialties - Cardiology |
Among women with coronary heart disease, advanced renal dysfunction predicts sudden cardiac death, according to findings from the Heart and Estrogen/Progestin Replacement Study (HERS).
"Among women with coronary heart disease, advanced renal dysfunction predicts sudden cardiac death, according to findings from the Heart and Estrogen/Progestin Replacement Study (HERS).
Whereas previous studies have shown that renal impairment predicts sudden cardiac death in patients with implantable cardioverter-defibrillators, the current study "extend[s] the observation...to a much healthier cohort," senior investigator Dr. Michael G. Shlipak and colleagues write in the June issue of Hypertension, published early online April 7.
To determine whether chronic kidney disease is a marker of heart failure severity or an independent predictor of sudden cardiac death,
Dr. Shlipak, at the University of California, San Francisco, and associates analyzed data on 2760 postmenopausal women 50 per cent narrowing of a coronary artery. Subjects with congestive heart failure greater than NYHA class II at baseline were excluded.
The women were stratified according to estimated glomerular filtration rate (eGFR) at baseline: >60 mL/min (n=1027), 40-60 mL/min (n=1503), and <40 mL/min (n=230).
During 6.8 years of follow-up, there were 135 sudden cardiac deaths.
After adjustment for sociodemographics, lifestyle, cardiovascular risk factors, and history of heart failure, eGFR <40 mL/min was significantly associated with an increased risk of sudden cardiac death (hazard ratio 3.2).
Further adjustment for incident congestive heart failure and MI during follow-up attenuated but did not eliminate risk, suggesting "that congestive heart failure and MI mediated only part of the association between kidney dysfunction and sudden cardiac death," the authors said.
Dr. Shlipak and associates point out, "Kidney dysfunction is less likely to be a proxy for heart failure severity." Rather, they conclude, "Advanced kidney dysfunction is an independent predictor of sudden cardiac death in women with coronary heart disease."
Whereas previous studies have shown that renal impairment predicts sudden cardiac death in patients with implantable cardioverter-defibrillators, the current study "extend[s] the observation...to a much healthier cohort," senior investigator Dr. Michael G. Shlipak and colleagues write in the June issue of Hypertension, published early online April 7.
To determine whether chronic kidney disease is a marker of heart failure severity or an independent predictor of sudden cardiac death,
Dr. Shlipak, at the University of California, San Francisco, and associates analyzed data on 2760 postmenopausal women 50 per cent narrowing of a coronary artery. Subjects with congestive heart failure greater than NYHA class II at baseline were excluded.
The women were stratified according to estimated glomerular filtration rate (eGFR) at baseline: >60 mL/min (n=1027), 40-60 mL/min (n=1503), and <40 mL/min (n=230).
During 6.8 years of follow-up, there were 135 sudden cardiac deaths.
After adjustment for sociodemographics, lifestyle, cardiovascular risk factors, and history of heart failure, eGFR <40 mL/min was significantly associated with an increased risk of sudden cardiac death (hazard ratio 3.2).
Further adjustment for incident congestive heart failure and MI during follow-up attenuated but did not eliminate risk, suggesting "that congestive heart failure and MI mediated only part of the association between kidney dysfunction and sudden cardiac death," the authors said.
Dr. Shlipak and associates point out, "Kidney dysfunction is less likely to be a proxy for heart failure severity." Rather, they conclude, "Advanced kidney dysfunction is an independent predictor of sudden cardiac death in women with coronary heart disease."
