Serum creatinine and coronary mortality in the elderly with normal renal function: The CArdiovascular STudy in the ELderly (CASTEL)

Mazza, Alberto
Pessina, Achille C.
Tikhonoff, Valèrie
Montemurro, Domenico
Casiglia, Edoardo

Department of Clinical and Experimental Medicine, University of Padua, Padua - Italy

Address for correspondence: Alberto Mazza, M.D., Ph.D. Department of Clinical and Experimental Medicine University of Padova Via Giustiniani, 2 I-35128 Padova, Italy[email protected]

Received: February 04, 2005

Revised: June 07, 2005

Accepted: August 08, 2005

Journal of Nephrology 18(5):p 606-612, 2005.

ABSTRACT:

Background:

Elevated serum creatinine (SCr) levels have been associated with increased mortality. Aim of this study is to evaluate whether SCr independently predicts coronary heart disease (CHD) mortality in a population of elderly with SCr values within the normal range.

Methods:

Three thousand two hundred and fifty-seven men and women aged ≥65 years were recruited in the population- based frame. Historical and clinical data, blood tests and 12-year fatal CHD events were recorded. SCr and creatinine clearance (Crcl) were divided into tertiles and, for each tertile, gender-specific adjusted relative risk (RR) with 95% confidence intervals (CI) for CHD mortality was calculated.

Results:

Both SCr and Crcl independently predicted CHD in men but not in women. In men CHD mortality increased with increasing SCr tertiles, being 1.5%, 5.5% (RR 2.51, CI 1.01–4.93) and 7.7% (RR 3.50, CI 1.41–5.88), respectively. The relationship between Crcl and CHD was inverse and increased with decreasing Crcl [2.7%, 3.3% (RR 1.42, CI 0.74–2.26) and 6.7% (RR 2.78, CI 1.56–4.12) in the 3rd, 2nd and 1st tertiles, respectively].

Conclusions:

SCr independently predicts CHD mortality in elderly men, but not in women. The increased CHD risk observed for SCr levels within the normal range is probably due to a sub-clinical impairment of renal function.