Predictive Value of Different Estimated Glomerular Filtration Rates on Hospital Adverse Events Following Acute Myocardial Infarction

ABSTRACT: to assess whether different glomerular fltration rate (GFR) equations render different predictive value on hospital adverse events in patients hospitalised due to acute myocardial infarction. Methods: the study design is cross-sectional. Data from consecutive patients with acute myocardial infarction were analyzed. Three different estimated GFR equations, i.e. Cockroft-Gault (eGFRC-G), MDRD (eGFRMDRD) and CKD-EPI (eGFRCKDEPI) were calculated. Hospital adverse events in these study patients were recorded. The predictive values of these eGFRs on hospital adverse events were compared with ROC curve. Univariate and multivariable analysis to assess which GFR equation as independent predictor for hospital adverse events were performed. Results: among 103 study patients, 49 patients (47.6%) experienced hospital adverse events. Proportion of hospital adverse events were signifcantly associated with eGFRMDRD (p<0.01) and eGFRCKD-EPI (p=0.02), but not with eGFRC-G (p=0.10). Hospital adverse events were better predicted by eGFRMDRD than by eGFRCKD-EPI (AUC, 0.698; 95%CI: 0.596-0.800, p<0.01 versus AUC, 0.693; 95%CI: 0.591-0.796, p<0.01). Multivariable analysis showed moderate (adjusted OR 3.50; 95%CI: 1.38-8.85, p<0.01) and severe (adjusted OR 8.13, 95%CI: 1.38-47.91, p=0.02) kidney dysfunctions based on eGFRMDRD were independent predictors for hospital adverse events. Conclusion: an eGFR based on MDRD gave better predictive value than eGFR based on CKD-EPI on hospital adverse events among acute myocardial infarction. Moderate and severe kidney dysfunctions based on eGFRMDRD were independent predictors for hospital adverse events following acute myocardial infarction.
Key words: glomerular fltration rate, MDRD, CKD-EPI, acute myocardial infarction
Penulis: Anggoro B. Hartopo, Budi Y. Setianto, Putrika P.R. Gharini
Kode Jurnal: jpkedokterangg130259