Impaired Renal Function and Major Cardiovascular Events in Young Adults.
cardiovascular disease
chronic
epidemiology
hypertension
kidney failure
prevention
Journal
Journal of the American College of Cardiology
ISSN: 1558-3597
Titre abrégé: J Am Coll Cardiol
Pays: United States
ID NLM: 8301365
Informations de publication
Date de publication:
26 09 2023
26 09 2023
Historique:
received:
03
05
2023
revised:
26
06
2023
accepted:
05
07
2023
medline:
22
9
2023
pubmed:
21
9
2023
entrez:
20
9
2023
Statut:
ppublish
Résumé
Cardiovascular (CV) disease in young adults (aged 18-39 years) is on the rise. Whether subclinical reductions in kidney function (ie, estimated glomerular filtration rate [eGFR] above the current threshold for chronic kidney disease but below age-expected values) are associated with elevated CV risk is unknown. The goal of this study was to examine age-specific associations of subclinical eGFR reductions in young adults with major adverse cardiovascular events (MACEs) and MACE plus heart failure (MACE+). A retrospective cohort study of 8.7 million individuals (3.6 million aged 18-39 years) was constructed using linked provincial health care data sets from Ontario, Canada (January 2008-March 2021). Cox models were used to examine the association of categorized eGFR (50-120 mL/min/1.73 m In the study cohort (mean age 41.3 years; mean eGFR 104.2 mL/min/1.73 m In young adults, eGFR below age-expected values were associated with an elevated risk for MACE and MACE+, warranting age-appropriate risk stratification, proactive monitoring, and timely intervention.
Sections du résumé
BACKGROUND
Cardiovascular (CV) disease in young adults (aged 18-39 years) is on the rise. Whether subclinical reductions in kidney function (ie, estimated glomerular filtration rate [eGFR] above the current threshold for chronic kidney disease but below age-expected values) are associated with elevated CV risk is unknown.
OBJECTIVES
The goal of this study was to examine age-specific associations of subclinical eGFR reductions in young adults with major adverse cardiovascular events (MACEs) and MACE plus heart failure (MACE+).
METHODS
A retrospective cohort study of 8.7 million individuals (3.6 million aged 18-39 years) was constructed using linked provincial health care data sets from Ontario, Canada (January 2008-March 2021). Cox models were used to examine the association of categorized eGFR (50-120 mL/min/1.73 m
RESULTS
In the study cohort (mean age 41.3 years; mean eGFR 104.2 mL/min/1.73 m
CONCLUSIONS
In young adults, eGFR below age-expected values were associated with an elevated risk for MACE and MACE+, warranting age-appropriate risk stratification, proactive monitoring, and timely intervention.
Identifiants
pubmed: 37730288
pii: S0735-1097(23)06287-3
doi: 10.1016/j.jacc.2023.07.012
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1316-1327Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Funding Support and Author Disclosures This study was supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health and the Ministry of Long-Term Care. Parts of this material are based on data and information compiled and provided by CIHI. The analyses, conclusions, opinions, and statements expressed herein are solely those of the authors and do not reflect those of CIHI. No endorsement is intended or should be inferred. Dr Tanuseputro is supported by a Physicians Services Incorporated Graham Farquharson Knowledge Translation Fellowship. Dr Tangri has received research support and honoraria from Bayer US. Dr Sood is supported by the Jindal Research Chair for the Prevention of Kidney Disease; and has received consultancy fees from AstraZeneca, Bayer, Otsuka, and GlaxoSmithKline. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.