The Prevalence, Outcome And Related Risk Assessment Of Chronic Kidney Disease In Older Patients With Coronary Artery Disease

亡。他们的死亡率均与NT-proBNP独立相关。7、NT-proBNP显著增加了GRACE RS和EHAS的AUC值。NT-proBNP本身AUC值也高于EHAS和GRACE RS,但与GRACE RS差异不明显。以NT-proBNP为基础的模型的AUC值明显高于GRACE RS或EHAS。8、血浆白蛋白等为NT-proBNP独立决定因素。结论：在中国老年冠心病患者中,慢性肾脏病具有高发病率和高死亡率的特点,且是全因死亡的独立危险因素。一些因素有助于判断慢性肾脏病或死亡的发生。MAYO较其它公式具有本身偏差小和准确判断预后等优势。不同公式判断死亡的最佳界值不同。无论使用何种公式,慢性肾脏病均具有针对这一人群的良好预后判断价值。NT-proBNP与众多因素相关,故相对于传统危险因素、GRACE RS和EHAS具备独立和补充的预后判断能力。另外,基于NT-proBNP能够建立有效的老年冠心病风险评估模型。 2.4×10^-3,-3.6×10^-3,4.2×10^-3 and-1.1×10^-3. The prevalence of CKD according toMDRD, CMDRD, CKD-EPI and MAYO was39.3%,35.4%,43.0%和28.7%. TheAUC values for death with respect to GFR estimated with MDRD, CMDRD,CKD-EPI and MAYO were0.611,0.610,0.625and0.632. The cutoff of MDRD,CMDRD, CKD-EPI and MAYO with the best accuracy of predicting death was at54.1,53.5,48.0and57.4mL/min/1.73m2, respectively. Compared with MDRD, NRIvalues of other equations were0.02,0.10and0.14.4. CKD was associated with mortality regardless of the equation used.5. The median of NT-proBNP was409.8pg/ml. Patients with ACS accounted for29.2%（292patients）. The median of GRACE RS was165for patients with ACS,while the median of EHAS was177for patients with stable CAD.6. In patients with stable CHD,138deaths were recorded （19.5%）.77（26.4%）patients with ACS had died. NT-proBNP was independently related to all-cause deathin patients with ACS and stable CAD.7. The addition of NT-proBNP to GRACE RS or EHAS generated the significantincrease of AUC. Even AUC of NT-proBNP was statistically above that of EHAS. Inspite of higher AUC of NT-proBNP compared with GRACE RS, there was nostatistically significant difference. The AUC of two models based on NT-proBNPwere obviously higher than that of GRACE RS or EHAS.4. There were independent relations of NT-proBNP with albumin and other factors.Conclusions: There was a high prevalence and mortality of CKD in Chinese olderpatients with CAD. CKD was independently correlated with mortality for patientswith CAD. Several characteristics could be used to identify CAD patients at increasedrisk for CKD or death. MAYO displayed more advantages such as less bias itself andbetter prognostic capacity. CKD could add to predictors of worse survival in Chineseolder patients with CAD regardless of the equation used. The cutoff values ofdifferent equations indicating a significant increase in mortality were different. Due toits relationships with several factors, NT-proBNP had incremental prognostic abilitiesbeyond many traditional biomarkers, GRACE RS and EHAS. New models based onNT-proBNP might be helpful in defining risk.