%0 Journal Article
%T Prognostic comparison between creatinine
%A Alfredo Zuppiroli
%A Antonio Fazi
%A Duccio Conti
%A Francesco Pizzarelli
%A Gaia Spaziani
%A Giovanni Maria Santoro
%A Giuseppe Ferro
%A Piercarlo Ballo
%A Pietro Dattolo
%A Santi Nigrelli
%A Tania Chechi
%A Veronica Fibbi
%J European Heart Journal: Acute Cardiovascular Care
%@ 2048-8734
%D 2018
%R 10.1177/2048872617697452
%X Estimated glomerular filtration rate (eGFR) is a predictor of outcome among patients with non-ST-elevation acute coronary syndrome (NSTE-ACS), but which estimation formula provides the best long-term risk stratification in this setting is still unclear. We compared the prognostic performance of four creatinine-based formulas for the prediction of 10-year outcome in a NSTE-ACS population treated by percutaneous coronary intervention. In 222 NSTE-ACS patients submitted to percutaneous coronary intervention, eGFR was calculated using four formulas: Cockcroft¨CGault, re-expressed modification of diet in renal disease (MDRD), chronic kidney disease epidemiology collaboration (CKD-Epi), and Mayo-quadratic. Predefined endpoints were all-cause death and a composite of cardiovascular death, non-fatal reinfarction, clinically driven repeat revascularisation, and heart failure hospitalisation. The different eGFR values showed poor agreement, with prevalences of renal dysfunction ranging from 14% to 35%. Over a median follow-up of 10.2 years, eGFR calculated by the CKD-Epi and Mayo-quadratic formulas independently predicted outcome, with an increase in the risk of death and events by up to 17% and 11%, respectively, for each decrement of 10 ml/min/1.73 m2. The Cockcroft¨CGault and MDRD equations showed a borderline association with mortality and did not predict events. When compared in terms of goodness of fit, discrimination and calibration, the Mayo-quadratic outperformed the other formulas for the prediction of death and the CKD-Epi showed the best performance for the prediction of events (net reclassification improvement values 0.33¨C0.35). eGFR is an independent predictor of long-term outcome in patients with NSTE-ACS treated by percutaneous coronary intervention. The Mayo-quadratic and CKD-Epi equations might be superior to classic eGFR formulas for risk stratification in these patients
%K Acute coronary syndrome
%K chronic kidney disease
%K glomerular filtration rate
%K mortality
%U https://journals.sagepub.com/doi/full/10.1177/2048872617697452