Abstract 18013: Which Measure of Renal Function is the Best Predictor of Outcome in Heart Failure? A Comparison of Cockcroft Gault, Modification of Diet in Renal Disease Study Group and Chronic Kidney Disease Epidemiology Collaboration Formulae
Introduction: Renal function is an important predictor of prognosis in heart failure (HF). Several formulae can be used to estimate glomerular filtration (eGFR) but which of these is best at predicting outcome in HF is uncertain. We compared the performance of the Cockcroft-Gault (CG), Modification of Diet in Renal Disease Study Group (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations in predicting all-cause mortality in patients with heart failure with reduced ejection fraction (HFrEF).
Methods: We studied the 5011 patients aged ≥60 years with symptomatic (NYHA class II-IV) HF of ischemic etiology and a LVEF ≤40% (≤35% in NYHA class II) enrolled in the Controlled Rosuvastatin Multinational Trial in Heart Failure trial (CORONA). Mortality rates were calculated for patients in the eGFR categories <45, 45-59 and ≥60 ml/min/1.73m2 (reference). The performance of the equations was compared using receiver operating characteristic curve (ROC) analysis.
Results: The rate and risk of death was highest in those with the lowest eGFR for each formula (Table). The area under the ROC for CG was 0.64, MDRD 0.59 (P<0.001 versus CG) and CKD-EPI 0.61 (P<0.0001 versus CG).
Conclusion: Risk prediction with CG was better than with MDRD or CKD-EPI in patients with HfrEF in CORONA.
†Rate per 100 patient years *Reference group
- © 2013 by American Heart Association, Inc.