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Cockcroft-Gault is better than the Modification of Diet in Renal Disease study formula at predicting outcome after a myocardial infarction: Data from the Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART)
Huddinge, Sweden.
Karolinska Institute.
Karolinska Institute.
Uppsala University Hospital.
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2010 (English)In: American Heart Journal, ISSN 0002-8703, E-ISSN 1097-6744, Vol. 159, no 6, 979-986 p.Article in journal (Refereed) Published
Abstract [en]

Background The aim was to examine whether the Modification of Diet in Renal Disease (MDRD) or the Cockcroft-Gault (CG) formula is better at predicting prognosis in myocardial infarction (MI) patients. Methods All consecutive MI patients entered in a nationwide registry between 2003 and 2006 with glomerular filtration rate (eGFR) estimated by both the MDRD and CG formula (N = 36,137) were analyzed. Results Cockcroft-Gault classified a larger proportion of patients as having at least a moderate (39.8% vs 31.1%, Pless than.001) or at least a severe renal dysfunction (7.6% vs 4.4%, Pless than.001) compared with the MDRD. The largest difference between the estimations was seen when patients were divided according to gender, age, and weight, where CG estimated a lower eGFR in women, the elderly, and those with low body weight. In a receiver operating characteristic analysis, CG had a stronger association to 1-year mortality (area under the curve 0.78, 95% CI 0.77-0.79) than MDRD (area under the curve 0.73, 95% CI 0.72-0.74). Within each renal function stage classified with the MDRD, there were patients identified with the CG as having both a worse renal function and a higher mortality. After multivariable adjustment, CG predicted 1-year mortality better than the MDRD (renal failure vs normal renal function: hazard ratio 3.00, 95% CI 2.42-3.71 with the CG; hazard ratio 2.56, 95% CI 2.10-3.11 with the MDRD). Conclusion Cockcroft-Gault is better than the MDRD equation at predicting mortality after a MI. This is mainly explained by differences in the coefficients and variables included in the eGFR equations, and less to differences in various subgroups of patients.

Place, publisher, year, edition, pages
Elsevier Science B.V., Amsterdam , 2010. Vol. 159, no 6, 979-986 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-58388DOI: 10.1016/j.ahj.2010.03.028ISI: 000278533200008OAI: diva2:343286
Available from: 2010-08-13 Created: 2010-08-11 Last updated: 2010-08-13

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Stenestrand, Ulf
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Cardiology Faculty of Health SciencesDepartment of Cardiology
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