TY - JOUR T1 - Chronic renal insufficiency and cardiovascular events in the elderly: findings from the Cardiovascular Health Study. JF - Am J Geriatr Cardiol Y1 - 2004 A1 - Shlipak, Michael G A1 - Fried, Linda F A1 - Stehman-Breen, Catherine A1 - Siscovick, David A1 - Newman, Anne B KW - Aged KW - Blood Coagulation Factors KW - Cardiovascular Diseases KW - Chronic Disease KW - Creatinine KW - Cystatin C KW - Cystatins KW - Female KW - Fibrinogen KW - Geriatric Assessment KW - Humans KW - Incidence KW - Male KW - Prevalence KW - Renal Insufficiency KW - Risk Factors AB -

In the Cardiovascular Health Study, the authors sought to evaluate the impact of chronic renal insufficiency (CRI) on cardiovascular risk status and outcomes in a representative sample of community-dwelling elderly adults. Defined as a serum creatinine level > or =1.3 mg/dL in women and > or =1.5 mg/dL in men, CRI was present in 647 (11%) of 5808 participants. At baseline, the prevalence of clinical or subclinical cardiovascular disease was 64% in participants with CRI and 43% in those without CRI (odds ratio, 2.34; 95% confidence interval, 1.96-2.80). The incidence of cardiovascular disease events during follow-up was 3% per year in participants with creatinine levels <1.10 mg/dL and increased steadily to reach 7% per year in those with creatinine > or =1.70 mg/dL. Among the possible mediators for the association between CRI and cardiovascular morbidity are inflammatory (C-reactive protein, fibrinogen, and interleukin-6) and hemostatic (factor VII, factor VIII, plasmin-antiplasmin product, and D-dimer) biomarkers, all of which were significantly elevated in Cardiovascular Health Study participants with CRI. Future studies should evaluate the contribution of novel and traditional cardiovascular risk factors to the cardiovascular risk of elderly persons with CRI. The identification of CRI in the elderly and the use of cardiovascular prevention therapies represent a major opportunity to reduce their burden of cardiovascular morbidity.

VL - 13 IS - 2 U1 - https://www.ncbi.nlm.nih.gov/pubmed/15010654?dopt=Abstract ER -