Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL.
Cardiovascular Division, University of Minnesota, Minneapolis, MN.
J Card Fail. 2024 Jan;30(1):14-22. doi: 10.1016/j.cardfail.2023.07.009. Epub 2023 Aug 4.
This study compared the predictive value of the race-independent creatinine- and cystatin C-based estimated glomerular filtration rate (eGFR) and the race-dependent creatinine-based eGFR (eGFR) for incident heart failure (HF).
This study combined the participant-level data from ARIC (Atherosclerosis Risk in Communities) (visit 4) and MESA (Multi-Ethnic Study of Atherosclerosis) (visit 1) to calculate eGFR and eGFR. The primary outcome of the study was adjudicated incident HF over a follow-up period of 10 years. Multivariable Cox models were used to assess the risk of incident HF with the quartiles of eGFR and eGFR.
Among 15,615 individuals (median age: 62 [57-68] years; 55.0% females; 23.9% Black), the median eGFR and eGFR were 91.4 (79.4, 102.0) mL/min/1.73m and 84.7 (72.0, 94.7) mL/min/1.73m, respectively. Compared with the fourth quartile of eGFR, the hazard ratio for incident HF was 1.02 (95% CI:0.80-1.30) in the third quartile, 1.02 (95% CI:0.80-1.30) in the second quartile, and 1.47 (95% CI:1.16-1.86) in the first quartile. Compared with the 4th quartile of the eGFR the risk of incident HF was similar in the 3rd (HR:0.90 [95% CI:0.73-1.12]), 2nd (HR: 0.96 [95% CI:0.77-1.20]), and 1st (HR:1.15 [95% CI:0.93-1.44]) quartiles. C-statistics were similar for the multivariable-adjusted Cox models for incident HF using eGFR (0.80 [0.79-0.81]) and eGFR (0.80 [0.79-0.82]).
The eGFR and eGFR had comparable predictive values for incident HF.
本研究比较了种族独立的基于肌酐和胱抑素 C 的估算肾小球滤过率（eGFR）与种族依赖的基于肌酐的 eGFR（eGFR）对心力衰竭（HF）的预测价值。
本研究将 ARIC（社区动脉粥样硬化风险）（第 4 次访视）和 MESA（多民族动脉粥样硬化研究）（第 1 次访视）的参与者水平数据合并，以计算 eGFR 和 eGFR。研究的主要结局是在 10 年的随访期间，经裁定的 HF 发生率。使用多变量 Cox 模型评估 eGFR 和 eGFR 四分位数与 HF 发生率的风险。
在 15615 名个体中（中位年龄：62 [57-68]岁；55.0%为女性；23.9%为黑人），中位 eGFR 和 eGFR 分别为 91.4（79.4，102.0）mL/min/1.73m 和 84.7（72.0，94.7）mL/min/1.73m。与 eGFR 的第 4 四分位相比，第 3 四分位的 HF 发生率的危险比为 1.02（95%CI：0.80-1.30），第 2 四分位为 1.02（95%CI：0.80-1.30），第 1 四分位为 1.47（95%CI：1.16-1.86）。与 eGFR 的第 4 四分位相比，HF 发生率在第 3 （HR：0.90 [95%CI：0.73-1.12]）、第 2 （HR：0.96 [95%CI：0.77-1.20]）和第 1 （HR：1.15 [95%CI：0.93-1.44]）四分位相似。使用 eGFR（0.80 [0.79-0.81]）和 eGFR（0.80 [0.79-0.82]）进行的多变量调整 Cox 模型对 HF 的预测值相似。
eGFR 和 eGFR 对 HF 的预测价值相当。
