Estimated kidney function based on serum cystatin c and risk of subsequent coronary artery calcium in young and middle-aged adults with preserved kidney function

Results from the CARDIA study

Nisha Bansal, Eric Vittinghoff, Carmen A. Peralta, Michael G. Shlipak, Vanessa Grubbs, David R. Jacobs, David Siscovick, Michael Steffes, John Jeffrey Carr, Kirsten Bibbins-Domingo

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Whether kidney dysfunction is associated with coronary artery calcium (CAC) in young and middle-aged adults who have a cystatin C-derived estimated glomerular filtration rate (eGFRcys) greater than 60 mL/min/1.73 m2 is unknown. In the Coronary Artery Risk Development in Young Adults (CARDIA) cohort (recruited in 1985 and 1986 in Birmingham, Alabama; Chicago, Illinois; Minneapolis, Minnesota; and Oakland, California), we examined 1) the association of eGFRcys at years 10 and 15 and detectable CAC over the subsequent 5 years and 2) the association of change in eGFRcys and subsequent CAC, comparing those with stable eGFRcys to those whose eGFRcys increased (>3% annually over 5 years), declined moderately (3%-5%), or declined rapidly (>5%). Generalized estimating equation Poisson models were used, with adjustment for age, sex, race, educational level, income, family history of coronary artery disease, diabetes, body mass index, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and tobacco use. Among 3,070 participants (mean age 35.6 (standard deviation, 4.1) years and mean eGFRcys 106.7 (standard deviation, 18.5) mL/min/1.73 m2), 529 had detectable CAC. Baseline eGFRcys was not associated with CAC. Moderate eGFRcys decline was associated with a 33% greater relative risk of subsequent CAC (95% confidence interval: 5, 68; P = 0.02), whereas rapid decline was associated with a 51% higher relative risk (95% confidence interval: 10, 208; P = 0.01) in adjusted models. In conclusion, among young and middle-aged adults with eGFRcys greater than 60 mL/min/1.73 m2, annual decline in eGFRcys is an independent risk factor for subsequent CAC.

Original languageEnglish (US)
Pages (from-to)410-417
Number of pages8
JournalAmerican Journal of Epidemiology
Volume178
Issue number3
DOIs
StatePublished - Aug 1 2013

Fingerprint

Cystatins
Young Adult
Coronary Vessels
Calcium
Kidney
Serum
Confidence Intervals
Cystatin C
Tobacco Use
Glomerular Filtration Rate
LDL Cholesterol
HDL Cholesterol
Coronary Artery Disease
Body Mass Index

Keywords

  • calcification
  • cardiovascular diseases
  • chronic kidney insufficiency
  • coronary arteries
  • coronary disease
  • cystatin C
  • glomerular filtration rate
  • kidney

Cite this

Estimated kidney function based on serum cystatin c and risk of subsequent coronary artery calcium in young and middle-aged adults with preserved kidney function : Results from the CARDIA study. / Bansal, Nisha; Vittinghoff, Eric; Peralta, Carmen A.; Shlipak, Michael G.; Grubbs, Vanessa; Jacobs, David R.; Siscovick, David; Steffes, Michael; Carr, John Jeffrey; Bibbins-Domingo, Kirsten.

In: American Journal of Epidemiology, Vol. 178, No. 3, 01.08.2013, p. 410-417.

Research output: Contribution to journalArticle

Bansal, Nisha ; Vittinghoff, Eric ; Peralta, Carmen A. ; Shlipak, Michael G. ; Grubbs, Vanessa ; Jacobs, David R. ; Siscovick, David ; Steffes, Michael ; Carr, John Jeffrey ; Bibbins-Domingo, Kirsten. / Estimated kidney function based on serum cystatin c and risk of subsequent coronary artery calcium in young and middle-aged adults with preserved kidney function : Results from the CARDIA study. In: American Journal of Epidemiology. 2013 ; Vol. 178, No. 3. pp. 410-417.
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abstract = "Whether kidney dysfunction is associated with coronary artery calcium (CAC) in young and middle-aged adults who have a cystatin C-derived estimated glomerular filtration rate (eGFRcys) greater than 60 mL/min/1.73 m2 is unknown. In the Coronary Artery Risk Development in Young Adults (CARDIA) cohort (recruited in 1985 and 1986 in Birmingham, Alabama; Chicago, Illinois; Minneapolis, Minnesota; and Oakland, California), we examined 1) the association of eGFRcys at years 10 and 15 and detectable CAC over the subsequent 5 years and 2) the association of change in eGFRcys and subsequent CAC, comparing those with stable eGFRcys to those whose eGFRcys increased (>3{\%} annually over 5 years), declined moderately (3{\%}-5{\%}), or declined rapidly (>5{\%}). Generalized estimating equation Poisson models were used, with adjustment for age, sex, race, educational level, income, family history of coronary artery disease, diabetes, body mass index, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and tobacco use. Among 3,070 participants (mean age 35.6 (standard deviation, 4.1) years and mean eGFRcys 106.7 (standard deviation, 18.5) mL/min/1.73 m2), 529 had detectable CAC. Baseline eGFRcys was not associated with CAC. Moderate eGFRcys decline was associated with a 33{\%} greater relative risk of subsequent CAC (95{\%} confidence interval: 5, 68; P = 0.02), whereas rapid decline was associated with a 51{\%} higher relative risk (95{\%} confidence interval: 10, 208; P = 0.01) in adjusted models. In conclusion, among young and middle-aged adults with eGFRcys greater than 60 mL/min/1.73 m2, annual decline in eGFRcys is an independent risk factor for subsequent CAC.",
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