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Renal function estimation and Cockcroft–Gault formulas for predicting cardiovascular mortality in population-based, cardiovascular risk, heart failure and post-myocardial infarction cohorts: The…

Overview of attention for article published in BMC Medicine, November 2016
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Title
Renal function estimation and Cockcroft–Gault formulas for predicting cardiovascular mortality in population-based, cardiovascular risk, heart failure and post-myocardial infarction cohorts: The Heart ‘OMics’ in AGEing (HOMAGE) and the high-risk myocardial infarction database initiatives
Published in
BMC Medicine, November 2016
DOI 10.1186/s12916-016-0731-2
Pubmed ID
Authors

João Pedro Ferreira, Nicolas Girerd, Pierpaolo Pellicori, Kevin Duarte, Sophie Girerd, Marc A. Pfeffer, John J. V. McMurray, Bertram Pitt, Kenneth Dickstein, Lotte Jacobs, Jan A. Staessen, Javed Butler, Roberto Latini, Serge Masson, Alexandre Mebazaa, Hans Peter Brunner-La Rocca, Christian Delles, Stephane Heymans, Naveed Sattar, J. Wouter Jukema, John G. Cleland, Faiez Zannad, Patrick Rossignol, for the Heart ‘OMics’ in AGEing (HOMAGE) initiative and the High-Risk Myocardial Infarction database initiative

Abstract

Renal impairment is a major risk factor for mortality in various populations. Three formulas are frequently used to assess both glomerular filtration rate (eGFR) or creatinine clearance (CrCl) and mortality prediction: body surface area adjusted-Cockcroft-Gault (CG-BSA), Modification of Diet in Renal Disease Study (MDRD4), and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. The CKD-EPI is the most accurate eGFR estimator as compared to a "gold-standard"; however, which of the latter is the best formula to assess prognosis remains to be clarified. This study aimed to compare the prognostic value of these formulas in predicting the risk of cardiovascular mortality (CVM) in population-based, cardiovascular risk, heart failure (HF) and post-myocardial infarction (MI) cohorts. Two previously published cohorts of pooled patient data derived from the partners involved in the HOMAGE-consortium and from four clinical trials - CAPRICORN, EPHESUS, OPTIMAAL and VALIANT - the high risk MI initiative, were used. A total of 54,111 patients were included in the present analysis: 2644 from population-based cohorts; 20,895 from cardiovascular risk cohorts; 1801 from heart failure cohorts; and 28,771 from post-myocardial infarction cohorts. Participants were patients enrolled in the respective cohorts and trials. The primary outcome was CVM. All formulas were strongly and independently associated with CVM. Lower eGFR/CrCl was associated with increasing CVM rates for values below 60 mL/min/m(2). Categorical renal function stages diverged in a more pronounced manner with the CG-BSA formula in all populations (higher χ(2) values), with lower stages showing stronger associations. The discriminative improvement driven by the CG-BSA formula was superior to that of MDRD4 and CKD-EPI, but remained low overall (increase in C-index ranging from 0.5 to 2 %) while not statistically significant in population-based cohorts. The integrated discrimination improvement and net reclassification improvement were higher (P < 0.05) for the CG-BSA formula compared to MDRD4 and CKD-EPI in CV risk, HF and post-MI cohorts, but not in population-based cohorts. The CKD-EPI formula was superior overall to MDRD4. The CG-BSA formula was slightly more accurate in predicting CVM in CV risk, HF, and post-MI cohorts (but not in population-based cohorts). However, the CG-BSA discriminative improvement was globally low compared to MDRD4 and especially CKD-EPI, the latter offering the best compromise between renal function estimation and CVM prediction.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 116 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 116 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 18 16%
Student > Master 12 10%
Student > Bachelor 8 7%
Student > Ph. D. Student 6 5%
Other 6 5%
Other 25 22%
Unknown 41 35%
Readers by discipline Count As %
Medicine and Dentistry 44 38%
Biochemistry, Genetics and Molecular Biology 4 3%
Nursing and Health Professions 4 3%
Pharmacology, Toxicology and Pharmaceutical Science 4 3%
Agricultural and Biological Sciences 2 2%
Other 12 10%
Unknown 46 40%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 16 November 2016.
All research outputs
#19,851,592
of 24,396,012 outputs
Outputs from BMC Medicine
#3,485
of 3,759 outputs
Outputs of similar age
#242,737
of 317,593 outputs
Outputs of similar age from BMC Medicine
#68
of 74 outputs
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