Prognostic impact of reduced kidney function in patients with suspected coronary artery disease undergoing CCTA

Jonathan N Dahl; Louise Nissen; Marie B Nielsen; Laust D Rasmussen; Jacob Hartmann Søby; Henrik Birn; Morten Bøttcher; Simon Winther

doi:10.1093/eurjpc/zwaf218

Prognostic impact of reduced kidney function in patients with suspected coronary artery disease undergoing CCTA

Jonathan N Dahl, Louise Nissen, Marie B Nielsen, Laust D Rasmussen, Jacob Hartmann Søby, Henrik Birn, Morten Bøttcher, Simon Winther

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

Abstract

AIMS: Chronic kidney disease (CKD) and coronary artery disease (CAD) share common risk factors, but the association between kidney function (estimated glomerular filtration rate (eGFR) in mL/min/1.73 m²) and major adverse cardiovascular events (MACE) in patients undergoing coronary computed tomography angiography (CCTA) due to suspected CAD has not been established. This study investigated the association between kidney function and MACE in symptomatic patients undergoing CCTA.

METHODS: A cohort study of consecutive, symptomatic patients undergoing CCTA between 2008 and 2021 (N=70,367). CAD severity was stratified as no CAD, non-obstructive CAD, and obstructive CAD (≥50% diameter stenosis). The primary outcome was MACE (myocardial infarction, ischemic stroke, or cardiovascular death). eGFR was calculated based on plasma creatinine at the time of CCTA.

RESULTS: In total, 41,156 (59%) had eGFR ≥90, 27,011 (38%) had eGFR 60-89, and 2200 (3%) had eGFR 30-59. Median follow-up were 5.1 years, according to eGFR ≥90, 60-89, and 30-59 groups, MACE rates per 1000 person-years in patients with obstructive CAD were 14.2, 15.4, and 25.8, respectively and in patients with non-obstructive CAD the MACE rates were 6.4, 8.0, and 14.4, respectively. Compared to patients with eGFR ≥90, hazard ratios for MACE were 1.09 (95% confidence intervals (CI) 1.00-1.19) and 1.42 (95%CI 1.18-1.69) for patients with eGFR 60-89 and 30-59, respectively.

CONCLUSION: In patients referred for CCTA due to suspected CAD, reduced kidney function was associated with an increased rate of MACE. Therefore, CKD is a strong independent cardiovascular risk factor, particularly in patients with CAD detected on CCTA.

Originalsprog	Engelsk
Tidsskrift	European Journal of Preventive Cardiology
ISSN	2047-4873
DOI	https://doi.org/10.1093/eurjpc/zwaf218
Status	E-pub / Early view - 18 apr. 2025

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10.1093/eurjpc/zwaf218

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@article{29cf1c30a613453db7e4266cb7b5e932,

title = "Prognostic impact of reduced kidney function in patients with suspected coronary artery disease undergoing CCTA",

abstract = "AIMS: Chronic kidney disease (CKD) and coronary artery disease (CAD) share common risk factors, but the association between kidney function (estimated glomerular filtration rate (eGFR) in mL/min/1.73 m²) and major adverse cardiovascular events (MACE) in patients undergoing coronary computed tomography angiography (CCTA) due to suspected CAD has not been established. This study investigated the association between kidney function and MACE in symptomatic patients undergoing CCTA.METHODS: A cohort study of consecutive, symptomatic patients undergoing CCTA between 2008 and 2021 (N=70,367). CAD severity was stratified as no CAD, non-obstructive CAD, and obstructive CAD (≥50% diameter stenosis). The primary outcome was MACE (myocardial infarction, ischemic stroke, or cardiovascular death). eGFR was calculated based on plasma creatinine at the time of CCTA.RESULTS: In total, 41,156 (59%) had eGFR ≥90, 27,011 (38%) had eGFR 60-89, and 2200 (3%) had eGFR 30-59. Median follow-up were 5.1 years, according to eGFR ≥90, 60-89, and 30-59 groups, MACE rates per 1000 person-years in patients with obstructive CAD were 14.2, 15.4, and 25.8, respectively and in patients with non-obstructive CAD the MACE rates were 6.4, 8.0, and 14.4, respectively. Compared to patients with eGFR ≥90, hazard ratios for MACE were 1.09 (95% confidence intervals (CI) 1.00-1.19) and 1.42 (95%CI 1.18-1.69) for patients with eGFR 60-89 and 30-59, respectively.CONCLUSION: In patients referred for CCTA due to suspected CAD, reduced kidney function was associated with an increased rate of MACE. Therefore, CKD is a strong independent cardiovascular risk factor, particularly in patients with CAD detected on CCTA.",

author = "Dahl, {Jonathan N} and Louise Nissen and Nielsen, {Marie B} and Rasmussen, {Laust D} and S{\o}by, {Jacob Hartmann} and Henrik Birn and Morten B{\o}ttcher and Simon Winther",

note = "{\textcopyright} The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected].",

year = "2025",

month = apr,

day = "18",

doi = "10.1093/eurjpc/zwaf218",

language = "English",

journal = "European Journal of Preventive Cardiology",

issn = "2047-4873",

publisher = "Oxford University Press",

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TY - JOUR

T1 - Prognostic impact of reduced kidney function in patients with suspected coronary artery disease undergoing CCTA

AU - Dahl, Jonathan N

AU - Nissen, Louise

AU - Nielsen, Marie B

AU - Rasmussen, Laust D

AU - Søby, Jacob Hartmann

AU - Birn, Henrik

AU - Bøttcher, Morten

AU - Winther, Simon

N1 - © The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected].

PY - 2025/4/18

Y1 - 2025/4/18

N2 - AIMS: Chronic kidney disease (CKD) and coronary artery disease (CAD) share common risk factors, but the association between kidney function (estimated glomerular filtration rate (eGFR) in mL/min/1.73 m²) and major adverse cardiovascular events (MACE) in patients undergoing coronary computed tomography angiography (CCTA) due to suspected CAD has not been established. This study investigated the association between kidney function and MACE in symptomatic patients undergoing CCTA.METHODS: A cohort study of consecutive, symptomatic patients undergoing CCTA between 2008 and 2021 (N=70,367). CAD severity was stratified as no CAD, non-obstructive CAD, and obstructive CAD (≥50% diameter stenosis). The primary outcome was MACE (myocardial infarction, ischemic stroke, or cardiovascular death). eGFR was calculated based on plasma creatinine at the time of CCTA.RESULTS: In total, 41,156 (59%) had eGFR ≥90, 27,011 (38%) had eGFR 60-89, and 2200 (3%) had eGFR 30-59. Median follow-up were 5.1 years, according to eGFR ≥90, 60-89, and 30-59 groups, MACE rates per 1000 person-years in patients with obstructive CAD were 14.2, 15.4, and 25.8, respectively and in patients with non-obstructive CAD the MACE rates were 6.4, 8.0, and 14.4, respectively. Compared to patients with eGFR ≥90, hazard ratios for MACE were 1.09 (95% confidence intervals (CI) 1.00-1.19) and 1.42 (95%CI 1.18-1.69) for patients with eGFR 60-89 and 30-59, respectively.CONCLUSION: In patients referred for CCTA due to suspected CAD, reduced kidney function was associated with an increased rate of MACE. Therefore, CKD is a strong independent cardiovascular risk factor, particularly in patients with CAD detected on CCTA.

AB - AIMS: Chronic kidney disease (CKD) and coronary artery disease (CAD) share common risk factors, but the association between kidney function (estimated glomerular filtration rate (eGFR) in mL/min/1.73 m²) and major adverse cardiovascular events (MACE) in patients undergoing coronary computed tomography angiography (CCTA) due to suspected CAD has not been established. This study investigated the association between kidney function and MACE in symptomatic patients undergoing CCTA.METHODS: A cohort study of consecutive, symptomatic patients undergoing CCTA between 2008 and 2021 (N=70,367). CAD severity was stratified as no CAD, non-obstructive CAD, and obstructive CAD (≥50% diameter stenosis). The primary outcome was MACE (myocardial infarction, ischemic stroke, or cardiovascular death). eGFR was calculated based on plasma creatinine at the time of CCTA.RESULTS: In total, 41,156 (59%) had eGFR ≥90, 27,011 (38%) had eGFR 60-89, and 2200 (3%) had eGFR 30-59. Median follow-up were 5.1 years, according to eGFR ≥90, 60-89, and 30-59 groups, MACE rates per 1000 person-years in patients with obstructive CAD were 14.2, 15.4, and 25.8, respectively and in patients with non-obstructive CAD the MACE rates were 6.4, 8.0, and 14.4, respectively. Compared to patients with eGFR ≥90, hazard ratios for MACE were 1.09 (95% confidence intervals (CI) 1.00-1.19) and 1.42 (95%CI 1.18-1.69) for patients with eGFR 60-89 and 30-59, respectively.CONCLUSION: In patients referred for CCTA due to suspected CAD, reduced kidney function was associated with an increased rate of MACE. Therefore, CKD is a strong independent cardiovascular risk factor, particularly in patients with CAD detected on CCTA.

U2 - 10.1093/eurjpc/zwaf218

DO - 10.1093/eurjpc/zwaf218

M3 - Journal article

C2 - 40249751

SN - 2047-4873

JO - European Journal of Preventive Cardiology

JF - European Journal of Preventive Cardiology

ER -

Prognostic impact of reduced kidney function in patients with suspected coronary artery disease undergoing CCTA

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