Adding eGFR, urinary albumin-to-creatinine ratio increases C statistic for risk prediction in overall population, those with diabetes
TUESDAY, March 9, 2021 (HealthDay News) — Adding measures of kidney function on top of the atherosclerotic CVD (ASCVD) risk score calculated with traditional factors improves prediction of future cardiovascular disease (CVD) risk, according to a study published online March 4 in the Journal of the American Society of Nephrology.
Yu Xu, M.D., Ph.D., from the Shanghai Jiaotong University School of Medicine, and colleagues studied 115,366 participants in the China Cardiometabolic Disease and Cancer Cohort study to assess CVD risks based on albumin-to-creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR; individually, together, and in combination using the Kidney Disease: Improving Global Outcomes [KDIGO] risk categories). Participants were aged 40 years and older and were examined prospectively for major CVD events.
The researchers identified 2,866 major CVD events during 415,111 person-years of follow-up. Across the KDIGO risk categories in ASCVD risk strata, incidence rates and multivariable-adjusted hazard ratios of CVD events increased significantly. After adding eGFR and log(ACR) to a model including the ASCVD risk score, increases in the C statistic for CVD risk prediction were 0.0116 and 0.0254 in the overall study population and in participants with diabetes, respectively. Significantly improved reclassification of CVD risks was seen with the addition of eGFR and log(ACR) to a model with the ASCVD score (net reclassification improvements, 4.78 percent).
“Consideration of nontraditional CVD risk factors such as eGFR and urinary ACR could further stratify future CVD risks on top of the ASCVD risk score calculated by traditional CVD risk factors,” the authors write.
One author disclosed financial ties to the pharmaceutical industry.
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