Glomerular filtration in elderly with acute coronary syndrome: is Cockcroft-Gault the best method?

• Autor(a) principal: Diniz,Lucas Rampazzo
• Data de Publicação: 2015
• Outros Autores: Garcia,Jessica Myrian de Amorim, Peixoto,Rafaella Italiano, Diniz,Keila Lima de Oliveira, Monteiro,Verônica Soares
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Geriatrics, Gerontology and Aging (Online)
• Texto Completo: https://ggaging.com/details/35
• topic: elderly; glomerular filtration rate; acute coronary syndrome.

<p><b>INTRODUCTION:</b> Subjects suffering from acute coronary syndrome and lower glomerular filtration rates are associated with worse outcomes. Although many different formulas to estimate glomerular filtration rates were developed, it has not been well established which one is more powerful to predict outcomes in elderly subjects with acute coronary syndrome.<br> <b>OBJECTIVE:</b> To compare three formulas for glomerular filtration rate in order to predict intra-hospital mortality and other outcomes.<br> <b>METHODS:</b> Intra-hospital retrospective cohort including elderly people with acute coronary syndrome, and who were admitted at an Intensive Care Unit of Cardiology between January 1^st and December 31^st, 2013. Cockcroft-gault, MDRD and CKD-EPI were used to calculate the glomerular filtration rate.<br> <b>RESULTS:</b> A hundred and twenty-two people were analyzed, 51.6% men, with a mean age of 73.5 years. The mortality was 19.6%. The mean glomerular filtration rates for Cockcroft-Gault, MDRD and CKD-EPI were, respectively, 70.24 mL/min. (± 33.35), 74.70 mL/min./1.73 m² (± 30.91), and 69.79 mL/min./1.73 m² (± 23.82). All formulas were associated with death (p<u>&lt;</u>0.001 <i>versus</i> 0.028 <i>versus</i> 0.028), use of antibiotics (p = 0.002 <i>versus</i> &lt; 0.001 <i>versus</i> 0.001), and hemodialysis (p <u>&lt;</u> 0.001 <i>versus</i> 0.003 <i>versus</i> 0.003). Using the ROC curve, the Cockcroft-Gault showed the highest predictive value (0.701 <i>versus </i>0.634 <i>versus</i> 0.639) and was the only one with statistical significance (95%CI 0.579 - 0.822, p = 0.006), for intra-hospital mortality.<br> <b>CONCLUSION:</b> The Cockcroft-Gault was the best formula to predict mortality.</p>