Copyright © 2003 by the European Society of Cardiology.
Regular Articles
Accelerated decline and prognostic impact of renal function after myocardial infarction and the benefits of ACE inhibition: the CATS randomized trial
a Trial Coordination Center/Department of Cardiology/Thoraxcenter, University Hospital Groningen, Hanzeplein 1, 9700 Groningen, The Netherlands
b Department of Clinical Pharmacology, State University Groningen, Groningen, The Netherlands
c Division of Nephrology, Department of Internal Medicine, University Hospital Groningen, Groningen, The Netherlands
d Julius Center for Patient Oriented Research, University Medical Center, Utrecht, The Netherlands
e Department of Internal Medicine, University Hospital Groningen, Groningen, The Netherlands
* Corresponding author. Tel.: +31-50-361-8066; fax: +31-50-361-8062
E-mail address: h.hillege{at}tcc.azg.nl
Received 31 May 2002; revised 15 July 2002; accepted 24 July 2002
Aims Information regarding the cardiorenal axis in patients after a myocardial infarction (MI) is limited. We examined the change in renal function after a first MI, the protective effect of angiotensin converting enzyme (ACE) inhibition and the prognostic value of baseline renal function.
Methods and results The study population consisted of 298 patients with a first anterior wall MI who were randomized to the ACE inhibitor captopril or placebo after completion of streptokinase infusion. Renal function, by means of glomerular filtration rate (GFR), was calculated using the Cockroft–Gault equation (GFRc). In the placebo group, renal function (GFRc) declined by 5.5mlmin–1within 1 year, vs only 0.5mlmin–1in the ACE inhibitor group 
. This beneficial effect of captopril was most pronounced in patients with the most compromised renal function at baseline. The incidence of chronic heart failure (CHF) within 1 year increased significantly with decreasing GFRc(divided into tertiles: 24.0, 28.9, and 41.2%; 
). The risk-ratio for GFRc<81mlmin–1vs >103mlmin–1was 1.86 (95% CI 1.11–3.13; 
).
Conclusions Renal function markedly deteriorates after a first MI, but is significantly preserved by ACE inhibition. Furthermore, an impaired baseline renal function adds to the prognostic risk of developing CHF in patients after a first anterior MI.
Key Words: Renal function • Myocardial infarction • Prognosis • Angiotensin converting enzyme inhibitors
CiteULike 
Connotea 
Del.icio.us What's this?
Related articles in EHJ:
- Looking for people at high cardiovascular risk? Look at serum-creatinine
- J.F.E Mann, I Dulau-Florea, and J Franke
EHJ 2003 24: 381-383.[Extract] [FREE Full Text]
This article has been cited by other articles:
|
|
 |
|
  G. C.M. Linssen, K. Damman, H. L. Hillege, G. Navis, D. J. van Veldhuisen, and A. A. Voors Urinary N-Terminal Prohormone Brain Natriuretic Peptide Excretion in Patients With Chronic Heart Failure Circulation, July 7, 2009; 120(1): 35 - 41. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Damman, V. M. van Deursen, G. Navis, A. A. Voors, D. J. van Veldhuisen, and H. L. Hillege Increased central venous pressure is associated with impaired renal function and mortality in a broad spectrum of patients with cardiovascular disease. J. Am. Coll. Cardiol., February 17, 2009; 53(7): 582 - 588. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Damman, D. J. van Veldhuisen, G. Navis, A. A. Voors, and H. L. Hillege Urinary neutrophil gelatinase associated lipocalin (NGAL), a marker of tubular damage, is increased in patients with chronic heart failure Eur J Heart Fail, October 1, 2008; 10(10): 997 - 1000. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. J. Howell, B. E. Keogh, R. S. Bonser, T. R. Graham, J. Mascaro, S. J. Rooney, I. C. Wilson, and D. Pagano Mild renal dysfunction predicts in-hospital mortality and post-discharge survival following cardiac surgery. Eur. J. Cardiothorac. Surg., August 1, 2008; 34(2): 390 - 395. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Schou, C. Torp-Pedersen, F. Gustafsson, J. Abdulla, and L. Kober Wall motion index, estimated glomerular filtration rate and mortality risk in patients with heart failure or myocardial infarction: A pooled analysis of 18,010 patients Eur J Heart Fail, July 1, 2008; 10(7): 682 - 688. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Damman, G. Navis, T. D.J. Smilde, A. A. Voors, W. van der Bij, D. J. van Veldhuisen, and H. L. Hillege Decreased cardiac output, venous congestion and the association with renal impairment in patients with cardiac dysfunction Eur J Heart Fail, September 1, 2007; 9(9): 872 - 878. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. L. Schiffrin, M. L. Lipman, and J. F.E. Mann Chronic Kidney Disease: Effects on the Cardiovascular System Circulation, July 3, 2007; 116(1): 85 - 97. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. C. Inglis, S. Stewart, A. Papachan, V. Vaghela, C. Libhaber, Y. Veriava, and K. Sliwa Anaemia and renal function in heart failure due to idiopathic dilated cardiomyopathy Eur J Heart Fail, April 1, 2007; 9(4): 384 - 390. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Redon, F. Morales-Olivas, A. Galgo, M. A. Brito, J. Mediavilla, R. Marin, P. Rodriguez, S. Tranche, J. V. Lozano, C. Filozof, et al. Urinary Albumin Excretion and Glomerular Filtration Rate across the Spectrum of Glucose Abnormalities in Essential Hypertension J. Am. Soc. Nephrol., December 1, 2006; 17(12_suppl_3): S236 - S245. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Jose, H. Skali, N. Anavekar, C. Tomson, H. M. Krumholz, J. L. Rouleau, L. Moye, M. A. Pfeffer, S. D. Solomon, and for the SAVE Investigators Increase in Creatinine and Cardiovascular Risk in Patients with Systolic Dysfunction after Myocardial Infarction J. Am. Soc. Nephrol., October 1, 2006; 17(10): 2886 - 2891. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Amann, C. Wanner, and E. Ritz Cross-Talk between the Kidney and the Cardiovascular System J. Am. Soc. Nephrol., August 1, 2006; 17(8): 2112 - 2119. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. L. Hillege, D. Nitsch, M. A. Pfeffer, K. Swedberg, J. J.V. McMurray, S. Yusuf, C. B. Granger, E. L. Michelson, J. Ostergren, J. H. Cornel, et al. Renal Function as a Predictor of Outcome in a Broad Spectrum of Patients With Heart Failure Circulation, February 7, 2006; 113(5): 671 - 678. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Westendorp, R. G. Schoemaker, H. Buikema, D. de Zeeuw, F. Boomsma, W. H. van Gilst, and D. J. van Veldhuisen Beneficial effects of add-on hydrochlorothiazide in rats with myocardial infarction optimally treated with quinapril Eur J Heart Fail, December 1, 2005; 7(7): 1085 - 1094. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Vanholder, Z. Massy, A. Argiles, G. Spasovski, F. Verbeke, N. Lameire, and for the European Uremic Toxin Work Group (EUTox) Chronic kidney disease as cause of cardiovascular morbidity and mortality Nephrol. Dial. Transplant., June 1, 2005; 20(6): 1048 - 1056. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. D. Sackner-Bernstein, H. A. Skopicki, and K. D. Aaronson Risk of Worsening Renal Function With Nesiritide in Patients With Acutely Decompensated Heart Failure Circulation, March 29, 2005; 111(12): 1487 - 1491. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. M.A. van de Wal, B. L. van Brussel, A. A. Voors, T. D.J. Smilde, J. C. Kelder, H. A. van Swieten, W. H. van Gilst, D. J. van Veldhuisen, and H.W. T. Plokker Mild preoperative renal dysfunction as a predictor of long-term clinical outcome after coronary bypass surgery J. Thorac. Cardiovasc. Surg., February 1, 2005; 129(2): 330 - 335. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. G. Bongartz, M. J. Cramer, P. A. Doevendans, J. A. Joles, and B. Braam The severe cardiorenal syndrome: 'Guyton revisited' Eur. Heart J., January 1, 2005; 26(1): 11 - 17. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. P. Tokmakova, H. Skali, S. Kenchaiah, E. Braunwald, J. L. Rouleau, M. Packer, G. M. Chertow, L. A. Moye, M. A. Pfeffer, and S. D. Solomon Chronic Kidney Disease, Cardiovascular Risk, and Response to Angiotensin-Converting Enzyme Inhibition After Myocardial Infarction: The Survival And Ventricular Enlargement (SAVE) Study Circulation, December 14, 2004; 110(24): 3667 - 3673. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. P.E. van Dokkum, W. B.A. Eijkelkamp, A. C.A. Kluppel, R. H. Henning, H. van Goor, M. Citgez, W. A.K.M. Windt, D. J. van Veldhuisen, P. A. de Graeff, and D. de Zeeuw Myocardial Infarction Enhances Progressive Renal Damage in an Experimental Model for Cardio-Renal Interaction J. Am. Soc. Nephrol., December 1, 2004; 15(12): 3103 - 3110. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. M. Gibson, D. S. Pinto, S. A. Murphy, D. A. Morrow, H.-P. Hobbach, S. D. Wiviott, R. P. Giugliano, C. P. Cannon, E. M. Antman, E. Braunwald, et al. Association of creatinine and creatinine clearance on presentation in acute myocardial infarction with subsequent mortality J. Am. Coll. Cardiol., November 5, 2003; 42(9): 1535 - 1543. [Abstract] [Full Text] [PDF]
|
|