Heart FailureInfluence of Age-Related Versus Non–Age-Related Renal Dysfunction on Survival in Patients With Left Ventricular Dysfunction
Section snippets
Methods
The Studies Of Left Ventricular Dysfunction (SOLVD) prevention and treatment trials were National Heart, Lung and Blood Institute–sponsored, randomized, double-blind, placebo-controlled trials of the effect of enalapril in patients with asymptomatic and symptomatic left ventricular dysfunctions and comprise the overall SOLVD population. Methods and results have been previously published.17, 18 Briefly, 4,228 patients were enrolled in the prevention trial and 2,569 patients in the treatment
Results
Baseline characteristics of patients in this analysis are presented in Table 1. The age of the population ranged from 27 to 80 years with a mean of 59 ± 10 years. The mean eGFR was 65.7 ml/min/1.73 m2 (SD = 19.0), which is 51.0% (41.3% to 59.2%) below a truly normal GFR of 130 ml/min/1.73 m2 (Figure 1). In the overall population, 35.1% (27.2% to 43.6%) of this deviation from true normal was consistent with expected age-related loss, and 62.9% (54.4% to 70.3%) was consistent with a
Discussion
The principal finding of this analysis was that the association between a low eGFR and survival appears to be significantly modified by whether the low eGFR was consistent with the normal aging process. Notably, in patients with a lower eGFR that was consistent with that which could be found with normal aging, eGFR demonstrated a weak association with mortality. However, patients with a low eGFR that could not be explained by normal age-related losses (i.e., disease-attributable loss in GFR)
Acknowledgment
This report was prepared using SOLVD research materials obtained from the National Heart, Lung and Blood Institute (NHLBI) Biologic Specimen and Data Repository Information Coordinating Center and does not necessarily reflect the opinions or views of the SOLVD study investigators or the NHLBI.
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