From the AtheroGene study 2135 patients were included. eGFR was calculated using the 4-variable Modification of Diet in Renal Disease (4MDRD) equation for serum creatinine (sCr), the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation for sCr and cystatin C (CysC) each alone, and in combination (CysC/sCr). eGFR was assessed regarding the combined outcome of cardiovascular death and non-fatal myocardial infarction and regarding complex CAD represented by a SYNTAX score ≥ 23. Median follow-up was 4.3 years.
40">Only the CKD-EPI equation using CysC could differentiate between eGFR > 90 ml/min/1.73 m2 vs. eGFR 60–90 ml/min/1.73 m2 according to the occurrence of an endpoint event (log-rank test p = 0.009). In the Cox regression analysis only eGFR calculated by CKD-EPI equation for CysC (Hazard ratio per 1 standard deviation (HR) 1.27 (95% CI 1.07–1.50); p = 0.007) and for CysC/sCr (HR 1.22 (95% CI 1.02–1.46); p = 0.026) were predictive regarding the outcome after adjustment for cardiovascular risk factors and Nt-proBNP. Furthermore, only eGFR calculated by CKD-EPI equation for CysC (odds ratio (OR) 1.57 (95% CI 1.36–1.78); p < 0.001) and for CysC/sCr (OR 1.32 (95% CI 1.13–1.53); p < 0.001) were significantly associated with a SYNTAX score ≥ 23.
45">In patients with CAD the CKD-EPI equation for CysC and for CysC/sCr provided the best predictive value regarding the prognosis and the severity of CAD.