Association between estimated glomerular filtration rate and 10-year atherosclerotic cardiovascular disease risk among community residents in Shanghai, China

Abstract

Background and aimsThe association between the estimated glomerular filtration rate (eGFR) and atherosclerotic cardiovascular disease (ASCVD) risk is unknown. We aimed to evaluate whether eGFR can be used as a predictor in ASCVD risk assessment. Methods and resultsUsing baseline data from 28,187 participants from Shanghai Suburban Adult Cohort and Biobank study, we adopted Pooled Cohort Equations (PCEs) and Prediction for ASCVD Risk in China (China-PAR) to estimate 10-year ASCVD risk. Multivariate logistic regression was used to analyze the relationship between 10-year ASCVD risk and eGFR. The receiver operating characteristic (ROC) curve was used to evaluate predictive value of eGFR for 10-year high ASCVD risk. Compared with normal eGFR, both men and women with reduced eGFR had a higher prevalence of ASCVD risk factors. With the decrease of eGFR level, the median of 10-year ASCVD risk gradually increased. For men, the adjusted odds ratios (95% confidence interval (CI)) of 10-year high ASCVD risk by PCEs associated with eGFR (60–74 and <60 mL/min/1.73 m2) were 1.52 (95%CI:1.17–1.99) and 2.51 (95%CI:1.27–4.97). The corresponding result was significant only for eGFR < 60 mL/min/1.73 m2, OR of 1.57 (1.14–2.18) for women. Using China-PAR, the adjusted OR of 10-year high risk associated with eGFR < 60 mL/min/1.73 m2 was 1.82 (1.40–2.38) in men. ROC indicated that eGFR has a good predictive value for 10-year high ASCVD risk. ConclusioneGFR may be an important risk factor in predicting and stratifying ASCVD risk. Consideration should be given to integrating eGFR into existing risk assessment tools to improve predictive performance.