{"id":29743,"date":"2012-06-19T15:35:29","date_gmt":"2012-06-19T19:35:29","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?post_type=news&#038;p=29743"},"modified":"2012-06-19T15:42:01","modified_gmt":"2012-06-19T19:42:01","slug":"is-chronic-kidney-disease-a-chd-risk-equivalent","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2012\/06\/19\/is-chronic-kidney-disease-a-chd-risk-equivalent\/","title":{"rendered":"Is Chronic Kidney Disease a CHD Risk Equivalent?"},"content":{"rendered":"<p><a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(12)60572-8\/fulltext?_eventId=login\">A study published in the <em>Lancet<\/em><\/a>\u00a0provides new data about whether chronic kidney disease (CKD) should, like diabetes, be considered a coronary heart disease (CHD) risk equivalent.<\/p>\n<p>Marcello Tonelli and colleagues analyzed data from a population of 1.25 million people in Alberta, Canada. During a median follow-up of 4 years, 11,340 people were admitted to the hospital for MI. People with a previous MI were at higher risk for MI admission than people with either diabetes or CKD:<\/p>\n<ul>\n<li>MI history: 18.5 per 1000 person-years (CI 17.4\u201319.8)<\/li>\n<li>Diabetes: 5.4 per 1000 person-years (5.2\u20135.7)<\/li>\n<li>CKD: 6.9 per 1000 person-years (6.6\u20137.2)<\/li>\n<\/ul>\n<div>After adjustment for other variables, the relative rate of MI was lower in the CKD group than in the diabetes group (rate and adjusted relative rate for MI admission):<\/p>\n<ul>\n<li>Previous MI: 7.7%, RR 3.8 (CI 3.5-41)<\/li>\n<li>Diabetes and CKD: 6%, RR 2.7 (2.5-2.9)<\/li>\n<li>CKD: 2.8%, RR 1.4 (1.3-1.5)<\/li>\n<li>Diabetes: 2.4%, RR 2.0 (1.9-2.1)<\/li>\n<li>No diabetes or CKD: 0.5%, RR 1 (reference)<\/li>\n<\/ul>\n<p>The authors write that their &#8220;data show that diabetes alone and chronic kidney disease alone &#8230; do not increase the rate of myocardial infarction to the same extent as does a history of coronary disease, and therefore do not support the use of the term coronary heart disease risk equivalent for either disorder.&#8221; However, they conclude that CKD should &#8220;be added to the list of criteria defining people at highest risk of future coronary events.&#8221;<\/p>\n<p>In\u00a0<a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(12)60772-7\/fulltext\">an accompanying comment<\/a>, Tamar Polonsky and George Bakris write that &#8220;despite negative findings for the primary outcome, compelling reasons are provided to consider lipid-lowering therapy in patients with chronic kidney disease.&#8221;<\/div>\n","protected":false},"excerpt":{"rendered":"<p>A study published in the Lancet\u00a0provides new data about whether chronic kidney disease (CKD) should, like diabetes, be considered a coronary heart disease (CHD) risk equivalent. Marcello Tonelli and colleagues analyzed data from a population of 1.25 million people in Alberta, Canada. During a median follow-up of 4 years, 11,340 people were admitted to the [&hellip;]<\/p>\n","protected":false},"author":196,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7],"tags":[1022,453,359,200,271],"class_list":["post-29743","post","type-post","status-publish","format-standard","hentry","category-prevention","tag-chd","tag-chronic-kidney-disease","tag-ckd","tag-diabetes","tag-risk-factors"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/29743","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=29743"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/29743\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=29743"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=29743"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=29743"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}