Comparison of Cockcroft-Gault and Modification of Diet in Renal Disease Formulas as Predictors of Cardiovascular Outcomes in Patients With Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention

Abstract

We prospectively assessed the value of estimated glomerular filtration rate (eGFR) by the Modification of Diet in Renal Disease (MDRD) and Cockcroft-Gault (C-G) equations in predicting inhospital adverse outcomes after primary coronary intervention for acute ST-segment elevation myocardial infarction. We classified 647 patients into 3 categories according to eGFR, <60, 60 to 90, and >90 mL/min/1.73 m2 . The eGFRC-G classified 17 patients in the >90 mL/min/1.73 m2 subgroup and 6 and 11 patients in the 60 to 90 and <60 mL/min/1.73 m2 subgroups, respectively. In multivariate analysis, patients with eGFRC-G < 60 mL/min/1.73 m2 had 19.5-fold (95% confidence interval [CI] 1.55-178) higher mortality risk and 5.48-fold (95% CI 1.75-24.21) higher major adverse cardiac events risk compared to patients with eGFRC-G >90 mL/min/1.73 m2 (P ¼ .01 and P ¼ .01, respectively); the eGFRMDRD was not predictive. Although the MDRD equation more accurately estimates GFR in certain populations, the CG formula may be a better predictor of adverse events.