CKD could earn a spot on the list of criteria defining individuals at highest risk of future coronary events, suggest the findings of a study led by Marcello Tonelli, MD, of the University of Alberta in Edmonton, and described online in The Lancet.
In a population-based cohort of 1,268,029 persons with measures of eGFR and proteinuria, 11,340 were hospitalized with myocardial infarction (MI) during a median follow-up of 48 months. The unadjusted MI rate was highest in those with previous MI (18.5 per 1,000 person-years). Among individuals without a previous MI, the rate of MI was higher in those with CKD but without diabetes (6.9 per 1,000 person-years) than in those with diabetes but without CKD (5.4 per 1,000 person-years). The rate of incident MI in patients with diabetes (6.6 per 1,000 person-years) was substantially lower than the rate for those with CKD (12.4 per 1,000 person-years) when defined by eGFR of less than 45 mL/min/1.73m2 and severely increased proteinuria (6.6 per 1,000 person-years).