Marcello Tonelli, MD, from the University of Alberta in Edmonton, Canada, and colleagues examined whether CKD should be considered as a coronary heart disease risk equivalent using a population-based cohort with measures of estimated glomerular filtration rate (eGFR) and proteinuria. The unadjusted rates and relative rates of MI during follow-up were calculated for five risk groups: individuals with previous MI (with or without diabetes or CKD) and four mutually exclusive groups of those without previous MI classified by the presence or absence of CKD and diabetes.
During a median follow-up of 48 months, the researchers found that 11,340 of 1,268,029 participants were admitted with MI. Individuals with previous MI had the highest unadjusted rate of MI (18.5 per 1,000 person-years). Among individuals without previous MI, the MI rate was lower for those with diabetes, without CKD, than for individuals with CKD, without diabetes (5.4 vs. 6.9 per 1,000 person-years). Compared to those with CKD, defined by eGFR of less than 45 mL/min/1.73 m² and severely increased proteinuria, the rate of incident MI was considerably lower for those with diabetes (6.6 vs.12.4 per 1,000 person-years).
“Our findings suggest that chronic kidney disease could be added to the list of criteria defining people at highest risk of future coronary events,” the authors wrote.