Renal Function and Risk of Myocardial Infarction in an Elderly Population

Abstract

Recent studies^1-7 have shown that renal failure is an independent risk factor for cardiovascular mortality and morbidity in high-risk populations such as patients with chronic kidney or cardiovascular disease and patients with cardiovascular risk factors. It remains uncertain whether the level of renal function within asymptomatic ranges predicts the risk of cardiovascular disease in the general population. Until now, population-based studies^8-12 on renal insufficiency and cardiovascular disease gave conflicting results. Most prospective studies have been conducted with middle-aged populations. In some of these studies,^8,9 renal insufficiency has been associated with increased risk of cardiovascular disease. In others,^10,11 renal insufficiency was not an independent predictor after adjustment for cardiovascular risk factors. The Cardiovascular Health Study^12,13 (CHS), a prospective population-based study of subjects 65 years or older, is the only study that has investigated the association between renal insufficiency and cardiovascular disease in elderly individuals. In this study, an increased risk of cardiovascular disease was foundin subjects with elevated serum cystatin C, whereas a much weaker association was found between serum creatinine level and risk of cardiovascular disease. No significant association between glomerular filtration rate (GFR) and risk of myocardial infarction was found.^12,13