Relative performance of three formulas to assess renal function at predicting in-hospital hemorrhagic complications in acute coronary syndrome population. What does the new CKD-EPI formula provide?

Grandío, Pilar Cabanas; Assi, Emad Abu; Roubín, Sergio Raposeiras; Lopez, E. Pereira; Romari, S. Gestal; Bermejo, Rosa María Agra; Cordero, M. Rodriguez; Acuna, J M Garcia; Juanatey, José Ramón González

doi:10.1093/eurheartj/eht310.4412

Cited by 3 publications

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“…Most previous studies have reported a progressive increase in MB events with lower levels of renal function during hospitalization for ACS [7][8][9][10]15,27,28]; however, there are less data on the relationship between renal function and bleeding events in the course of follow-up after hospital discharge [29,30]. In a cohort of 7431 ACS patients, Fischer et al [30] found a twofold increase in MB during 1-year follow-up after an ACS in patients with estimated GFR < 30 mL/min/1Á73 m 2 compared with estimated GFR > 60 mL/min/1Á73 m 2 using an SCr-based CKD-EPI equation.…”

Section: Discussionmentioning

confidence: 99%

Major bleeding risk prediction using Chronic Kidney Disease Epidemiology Collaboration and Modification of Diet in Renal Disease equations in acute coronary syndrome

Flores-Blanco

Januzzi

Marı́n

et al. 2015

Eur J Clin Investigation

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Section: Discussionmentioning

confidence: 99%

Major bleeding risk prediction using Chronic Kidney Disease Epidemiology Collaboration and Modification of Diet in Renal Disease equations in acute coronary syndrome

Flores-Blanco

Januzzi

Marı́n

et al. 2015

Eur J Clin Investigation

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“…In a nationwide registry in Sweden, Cockcroft‐Gault equation was better than the MDRD equation in predicting mortality after a myocardial infarction, and seems to be superior for predicting short‐ and long‐term mortality . In addition, a study has suggested that the Cockcroft‐Gault equation may improve risk prediction of in‐hospital bleeding more than the MDRD‐4 or the CKD‐EPI equation in patients with ACS …”

Section: Discussionmentioning

confidence: 99%

Disparities in the Estimation of Glomerular Filtration Rate According to Cockcroft‐Gault, Modification of Diet in Renal Disease‐4, and Chronic Kidney Disease Epidemiology Collaboration Equations and Relation With Outcomes in Patients With Acute Coronary Syndrome

Rivera‐Caravaca

Ruiz-Nodar

Tello‐Montoliu

et al. 2018

JAHA

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BackgroundA simple method to assess renal function is the estimated glomerular filtration rate, and it shows prognostic implications. However, it remains unknown which equation should be used in patients with acute coronary syndrome. We compared the ability and correlation of the Cockcroft‐Gault, Modification of Diet in Renal Disease‐4 (MDRD‐4), and Chronic Kidney Disease Epidemiology Collaboration (CKD‐EPI) equations and their predictive performance for major adverse cardiovascular events, all‐cause mortality, and major bleeding in a cohort of patients with acute coronary syndrome.Methods and ResultsMulticenter prospective registry involving 1699 consecutive patients with acute coronary syndrome from 3 tertiary institutions. At entry, renal function was assessed using the Cockcroft‐Gault, MDRD‐4, and CKD‐EPI‐creatinine equations. During 12 months of follow‐up, we recorded all major adverse cardiovascular events (composite of cardiovascular death, nonfatal myocardial infarction, and nonfatal ischemic stroke), bleeding events (Bleeding Academic Research Consortium classification), and all‐cause mortality. Receiver operating characteristic curve comparisons demonstrated that Cockcroft‐Gault equation had higher predictive ability compared with MDRD‐4 equation for major adverse cardiovascular events (0.651 versus 0.616; P=0.023), major bleeding (0.600 versus 0.551; P=0.005), and all‐cause mortality (0.754 versus 0.717; P=0.033), as well as higher predictive ability compared with CKD‐EPI equation for major bleeding (0.600 versus 0.564; P=0.018). Integrated discrimination improvement and net reclassification improvement analyses showed superior discrimination and reclassification of Cockcroft‐Gault equation. Decision curve analyses graphically demonstrated higher net benefit and clinical usefulness of the Cockcroft‐Gault equation in comparison with MDRD‐4 and CKD‐EPI equations.ConclusionsIn patients with acute coronary syndrome, the Cockcroft‐Gault equation presented superior predictive ability for major adverse cardiovascular events, major bleeding, and all‐cause mortality compared with MDRD‐4 equation, and superior predictive ability for major bleeding compared with CKD‐EPI equation. The Cockcroft‐Gault equation also showed higher net benefit and clinical usefulness.

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“…This study was not designed to assess the prognostic value of different GFR estimates for the prediction of bleeding events. 47 Age was recently shown to impact on the association between CKD and the risk of future coronary events in the general population. 48 The sample size of this single-centre study did not allow us to explore potential interactions with age in our NSTE-ACS population.…”

Section: Discussionmentioning

confidence: 99%

Prognostic comparison between creatinine-based glomerular filtration rate formulas for the prediction of 10-year outcome in patients with non-ST elevation acute coronary syndrome treated by percutaneous coronary intervention

Ballo

Chechi

Spaziani

et al. 2017

European Heart Journal: Acute Cardiovascular Care

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Relative performance of three formulas to assess renal function at predicting in-hospital hemorrhagic complications in acute coronary syndrome population. What does the new CKD-EPI formula provide?

Cited by 3 publications

References 0 publications

Major bleeding risk prediction using Chronic Kidney Disease Epidemiology Collaboration and Modification of Diet in Renal Disease equations in acute coronary syndrome

Major bleeding risk prediction using Chronic Kidney Disease Epidemiology Collaboration and Modification of Diet in Renal Disease equations in acute coronary syndrome

Disparities in the Estimation of Glomerular Filtration Rate According to Cockcroft‐Gault, Modification of Diet in Renal Disease‐4, and Chronic Kidney Disease Epidemiology Collaboration Equations and Relation With Outcomes in Patients With Acute Coronary Syndrome

Prognostic comparison between creatinine-based glomerular filtration rate formulas for the prediction of 10-year outcome in patients with non-ST elevation acute coronary syndrome treated by percutaneous coronary intervention

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