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比较 Cockcroft-Gault 和改良肾脏病饮食公式在接受直接经皮冠状动脉介入治疗的心肌梗死患者中的心血管结局预测作用。

Comparison of Cockcroft-Gault and modification of diet in renal disease formulas as predictors of cardiovascular outcomes in patients with myocardial infarction treated with primary percutaneous coronary intervention.

机构信息

Clinic of Cardiology, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey.

Department of Cardiology, Kadirli State Hospital, Osmaniye, Turkey

出版信息

Angiology. 2014 Oct;65(9):838-43. doi: 10.1177/0003319713505899. Epub 2013 Oct 7.

DOI:10.1177/0003319713505899
PMID:24101712
Abstract

We prospectively assessed the value of estimated glomerular filtration rate (eGFR) by the Modification of Diet in Renal Disease (MDRD) and Cockcroft-Gault (C-G) equations in predicting inhospital adverse outcomes after primary coronary intervention for acute ST-segment elevation myocardial infarction. We classified 647 patients into 3 categories according to eGFR, <60, 60 to 90, and >90 mL/min/1.73 m(2). The eGFRC-G classified 17 patients in the >90 mL/min/1.73 m(2) subgroup and 6 and 11 patients in the 60 to 90 and <60 mL/min/1.73 m(2) subgroups, respectively. In multivariate analysis, patients with eGFRC-G < 60 mL/min/1.73 m(2) had 19.5-fold (95% confidence interval [CI] 1.55-178) higher mortality risk and 5.48-fold (95% CI 1.75-24.21) higher major adverse cardiac events risk compared to patients with eGFRC-G >90 mL/min/1.73 m(2) (P = .01 and P = .01, respectively); the eGFRMDRD was not predictive. Although the MDRD equation more accurately estimates GFR in certain populations, the CG formula may be a better predictor of adverse events.

摘要

我们前瞻性评估了改良肾脏病饮食研究(MDRD)和 Cockcroft-Gault(C-G)方程估计肾小球滤过率(eGFR)在预测急性 ST 段抬高型心肌梗死患者行直接经皮冠状动脉介入治疗后住院期间不良结局的价值。我们根据 eGFR 将 647 例患者分为 3 组,eGFR<60、60-90 和>90 mL/min/1.73 m(2)。eGFR-C-G 将 17 例患者分到>90 mL/min/1.73 m(2)亚组,将 6 例和 11 例患者分到 60-90 和<60 mL/min/1.73 m(2)亚组。多变量分析显示,eGFR-C-G<60 mL/min/1.73 m(2)的患者死亡风险比 eGFR-C-G>90 mL/min/1.73 m(2)的患者高 19.5 倍(95%置信区间 [CI] 1.55-178),主要不良心脏事件风险高 5.48 倍(95% CI 1.75-24.21)(P=.01 和 P=.01);MDRD 方程没有预测作用。虽然 MDRD 方程在某些人群中更准确地估计 GFR,但 C-G 公式可能是不良事件的更好预测指标。

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