Kidney Week

Abstract: FR-PO341

Intraindividual Difference between Creatinine- and Cystatin C-Based GFR and Association with Cardiovascular Events

Session Information

• Hypertension, CVD, and the Kidneys: Epidemiology
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Hypertension and CVD

• 1602 Hypertension and CVD: Clinical

Authors

• Tydén, Maria, Uppsala Universitet Institutionen for Medicinska Vetenskape, Uppsala, Sweden

Maria Tydén, MD

• Batra, Gorav, Uppsala Universitet Institutionen for Medicinska Vetenskape, Uppsala, Sweden

Gorav Batra, MD, PhD

• Fellstrom, Bengt C., Uppsala Universitet Institutionen for Medicinska Vetenskape, Uppsala, Sweden

Bengt C. Fellstrom, MD, PhD

• Held, Claes Olov Gunnar, Uppsala Universitet Institutionen for Medicinska Vetenskape, Uppsala, Sweden

Claes Olov Gunnar Held, MD, PhD

• Lindbäck, Johan, Uppsala Clinical Research Center, Uppsala, Sweden

Johan Lindbäck

• Soveri, Inga, Uppsala Universitet Institutionen for Medicinska Vetenskape, Uppsala, Sweden

Inga Soveri, MD, PhD

• Stewart, Ralph A., Green Lane Cardiovascular Service, Auckland City Hospital and Auckland University, Auckland, New Zealand

Ralph A. Stewart, MD, MBChB

• Svensson, Maria K., Uppsala Universitet Institutionen for Medicinska Vetenskape, Uppsala, Sweden

Maria K. Svensson, MD, PhD

• White, Harvey D., Green Lane Cardiovascular Service, Auckland City Hospital and Auckland University, Auckland, New Zealand

Harvey D. White, MBChB

• Wallentin, Lars, Uppsala Universitet Institutionen for Medicinska Vetenskape, Uppsala, Sweden

Lars Wallentin, MD, PhD

Background

Association between eGFR_ratio (eGFR_cys/eGFR_cr) and outcomes, was studied in patients with chronic coronary syndrome.

Methods

A post-hoc analysis of 14,513 patients from the STABILITY trial investigated the association between baseline eGFR_ratio and major adverse cardiac events (MACE) and death using Cox-regression. Analyses were adjusted for eGFR_cr, eGFR_cys, or both. Discriminative ability was assessed using the C-index, and the incremental value was measured using the fraction of new information (FNI). 2021 CKD-EPI eGFR equations were applied.

Results

The mean age was 65 years, 82% were male. Mean eGFR_cys was 77 (61-94) and eGFR_cr 79 (65-91) mL/min/1.73 m². During median follow-up of 3.7 years, there were 1449 MACE and 1063 deaths. Table 1 presents a comparison of eGFR_ratio of 0.7 with 1.0. After adjustment for eGFR_cys, the eGFR_ratio contributed marginally when assessed by FNI. Figure 1 illustrates the adjusted one-year-risk for MACE and death as a function of eGFR_ratio for different eGFR levels, indicating a weaker association with the ratio when adjusted for eGFR_cys.

Conclusion

In patients with chronic coronary syndrome, lower eGFR_ratio is associated with higher risk of adverse outcomes. After adjustment for eGFR_cys the added value of eGFR_ratio is limited.

eGFRratio and outcomes

Funding

• Commercial Support – GlaxoSmithKline