27 What is the relationship between chronic kidney disease and subsequent events in a coronary heart disease population? A secondary analysis of the euroaspire V data. (30th September 2020) - Coyle, M
Abstract : Introduction: Chronic kidney disease (CKD) is an important risk factor for cardiovascular disease (CVD). The EUROASPIRE V study, conducted across 27 European countries (2016–2017), investigated whether the European guidelines on secondary CVD prevention were being met. Aims: The aim of this secondary analysis of the EUROASPIRE V data was to compare the CVD event-rate in those with and without CKD (defined as an eGFR <60 ml/min/1.73 m²). Methods: A cohort study was conducted of patients who were interviewed between 6–24 months after an index hospitalisation for coronary heart disease (CHD). Follow-up was subsequently performed at least 12 months after the interview to record new CVD events. The primary outcome was a composite of fatal and non-fatal CVD. Multivariable-adjusted Cox regression analysis was performed. Results: Of the 8251 participants who attended the interview, 2126 (25.8%) were female. The majority (7060, 86%) were Caucasian. In total, 1303 (16.7%) had CKD. The prevalence of CVD risk factors are outlined in table 1 . At follow-up 7509 (98.5%) were alive. Of those that died, 37 (51.39%) deaths were due to CHD (figure 1 ). Regarding non-fatal events, 135 (1.8%) were hospitalised for myocardial infarction (MI) during follow-up and 84 (1.1%) were hospitalised for a stroke/TIA. Among those with recurrent CVD events (i) mean eGFR (95% CI) was 14.9 ml/min/1.73 m² lower in persons suffering fatal CVD vs. others (6.5, 23.4) p= 0.001 (ii) eGFR was 7.23 ml/min/1.73 m² lower in stroke than no stroke (2.16, 12.31) p= 0.006 (iii) eGFR was 1.56 ml/min/1.73 m² lower in MI than no MI (-3.03, 6.14) p= 0.503. (Table 2, figure 2 ) Adjusted hazard ratio (95% CI) for CV events in those with CKD versus those without: (i) CVD Death 1.305 (0.519, 3.279) p= 0.572 (ii) MI 1.228 (0.753, 2.000) p= 0.410 (iii) Stroke 1.563 (0.864, 2.828) p= 0.14. Conclusion: A sixth of the European CHD population has CKD. Participants who had a stroke or died from CVD over follow-up had a statistically significantly lower baseline eGFR than those who did not. The HR suggest an increased risk for CV events in CKD but this was not statistically significant. Further studies with a longer follow-up period are needed in this area.