Predicting outcomes after myocardial infarction by using the Chronic Kidney Disease Epidemiology Collaboration equation in comparison with the Modification of Diet in Renal Disease study equation: results from the Korea Acute Myocardial Infarction Registry

Abstract

The presence of chronic kidney disease is an independent prognostic factor in patients with myocardial infarction (MI). We compared the Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equation and the Modification of Diet in Renal Disease (MDRD) study equation with regard to prognostic value in patients with MI. This study analyzed a retrospective cohort of 11 050 consecutive patients who had MI and were enrolled in the Korea Acute Myocardial Infarction Registry from November 2005 to August 2008. We applied the CKD-EPI equation and the MDRD study equation to determine the estimated glomerular filtration rate (eGFR) in a cohort of patients with MI. The mean eGFR(CKD-EPI) was slightly higher than that of eGFR(MDRD) (73.16 versus 72.23 mL/min/1.73 m(2); P < 0.001). The prevalence of eGFR(CKD-EPI) <60 mL/min/1.73 m(2) was 26.9%, whereas that of eGFR(MDRD) was 28.5%. The area under the receiver operating characteristic curve was significantly larger for predicting the 1-year major adverse cardiovascular event (MACE) and 1-year all-cause mortality with CKD-EPI equation (0.648 versus 0.641, 0.768 versus 0.753, respectively; P < 0.001). The net reclassification index for improvement in risk of 1-year MACE and 1-year all-cause mortality were 4.09% (P< 0.001) and 9.25% (P< 0.001), respectively. The application of the eGFR(CKD-EPI) demonstrated better predictive values for clinical outcomes than eGFR(MDRD) in a cohort of patients with MI.