肾功能是伴有明确动脉疾病史的患者发生心血管事件的预测因子
2009-05-26 20:36:19 来源： 作者： 评论：0 点击：
Renal function as a risk indicator for cardiovascular events in 3216 patients with manifest arterial dise
肾功能是伴有明确动脉疾病史的患者发生心血管事件的预测因子
Abstract
Aim
To establish whether impaired renal function is an independent predictor of cardiovascular disease (CVD) and death in an unselected high-risk population with CVD.
Methods and results
摘要
目的
为了确定肾功受损是否是心血管事件和非选择性高风险合并心血管病死亡的的独立预测因素。
In 3216 patients with CVD, the estimated glomerular filtration rate (GFR) was assessed with the Modification of Diet in Renal Disease (MDRD)-equation. Primary outcomes were all vascular events (including stroke, myocardial infarction, end-stage renal disease and vascular death) and all cause death. During a median follow-up of 39 months, 378 patients had a vascular event (11.7%) and 337 patients died (10.5%). The adjusted hazard ratio (HR) of an estimated GFR ≤ 60 versus >90 ml/min per 1.73 m2 was 1.8 (95% CI, 1.2–2.6) for vascular events and 1.4 (95% CI 0.9–2.0) for all cause death. For stroke and cardiac events as separate outcomes, similar HR's were found. Subgroup analysis according to localization of vascular disease at presentation or presence of the risk factors hypertension, diabetes and albuminuria had no influence on the hazard ratios.
在合并CVD的3216名患者中，肾脏膳食改良方程中评估肾小球率过滤。主要结果为所以血管事件（包括脑卒中、心肌梗死、晚期肾衰和血管病导致的死亡）及全因死亡。中期随访时间39个月，378名患者出现血管事件（11.7%)，337名患者死亡(10.5%)。评估GFR调整风险比血管时间为1.8.（每1.73平方米体表面积GFR≤60 ml/min 与>90 ml/min）（95的可信区间：1.2-2.6）。全因死亡为1.4（95% 可信区间： 0.9–2.0）。脑卒中和心脏事件作为不同的结果，发现有相似的危险比。根据对局部血管疾病或表现为高血压、糖尿病、蛋白尿的危险因素的亚组分析，未发现对危险比有影响。
Conclusions
The presence of moderate to severe renal insufficiency is an independent risk factor for adverse CVD events in high-risk patients with a history of vascular disease. Localization of vascular disease or presence of other risk factors had no influence on the impact of renal function alone.
结论：
中-重度的肾功能不全是有动脉疾病史患者发生不利心血管事件的独立风险提示因子。
局部或血管疾病、其它危险因素不作为如肾功能一样独立影响因素。
肾功能是伴有明确动脉疾病史的患者发生心血管事件的预测因子
Abstract
Aim
To establish whether impaired renal function is an independent predictor of cardiovascular disease (CVD) and death in an unselected high-risk population with CVD.
Methods and results
摘要
目的
为了确定肾功受损是否是心血管事件和非选择性高风险合并心血管病死亡的的独立预测因素。
In 3216 patients with CVD, the estimated glomerular filtration rate (GFR) was assessed with the Modification of Diet in Renal Disease (MDRD)-equation. Primary outcomes were all vascular events (including stroke, myocardial infarction, end-stage renal disease and vascular death) and all cause death. During a median follow-up of 39 months, 378 patients had a vascular event (11.7%) and 337 patients died (10.5%). The adjusted hazard ratio (HR) of an estimated GFR ≤ 60 versus >90 ml/min per 1.73 m2 was 1.8 (95% CI, 1.2–2.6) for vascular events and 1.4 (95% CI 0.9–2.0) for all cause death. For stroke and cardiac events as separate outcomes, similar HR's were found. Subgroup analysis according to localization of vascular disease at presentation or presence of the risk factors hypertension, diabetes and albuminuria had no influence on the hazard ratios.
在合并CVD的3216名患者中，肾脏膳食改良方程中评估肾小球率过滤。主要结果为所以血管事件（包括脑卒中、心肌梗死、晚期肾衰和血管病导致的死亡）及全因死亡。中期随访时间39个月，378名患者出现血管事件（11.7%)，337名患者死亡(10.5%)。评估GFR调整风险比血管时间为1.8.（每1.73平方米体表面积GFR≤60 ml/min 与>90 ml/min）（95的可信区间：1.2-2.6）。全因死亡为1.4（95% 可信区间： 0.9–2.0）。脑卒中和心脏事件作为不同的结果，发现有相似的危险比。根据对局部血管疾病或表现为高血压、糖尿病、蛋白尿的危险因素的亚组分析，未发现对危险比有影响。
Conclusions
The presence of moderate to severe renal insufficiency is an independent risk factor for adverse CVD events in high-risk patients with a history of vascular disease. Localization of vascular disease or presence of other risk factors had no influence on the impact of renal function alone.
结论：
中-重度的肾功能不全是有动脉疾病史患者发生不利心血管事件的独立风险提示因子。
局部或血管疾病、其它危险因素不作为如肾功能一样独立影响因素。
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