Mild impairment of renal function (shrunken pore syndrome) is associated with increased risk of a future first-ever myocardial infarction in women

• Main Authors: Elisabet Söderström (11100010), Ravna Blind (11100013), Patrik Wennberg (3132933), Jonas Andersson (3905224), Stefan Söderberg (632656), Torbjörn K. Nilsson (3132927), Johan Hultdin (326756)
• Format: Other Non-Article Part of Journal/Newspaper
• Language: unknown
• Published: 2021
• Subjects: Medicine; Marine Biology; Cancer; Science Policy; Biological Sciences not elsewhere classified; Chemical Sciences not elsewhere classified; Myocardial infarction; creatinine; cystatin C; glomerular filtration rate; chronic renal insufficiency; shrunken pore syndrome; Northern Sweden
• Online Access: https://doi.org/10.6084/m9.figshare.14935834.v1

Impaired renal function is associated both with the development of cardiovascular disease and its prognosis. A new syndrome called ′Shrunken Pore Syndrome′ has been suggested, as the estimated glomerular filtration rate for cystatin C (eGFR cystatin C ) is affected earlier due to differences in molecular size compared to eGFR creatinine . The aim was to investigate if a lower eGFR cystatin C /eGFR creatinine ratio in a prospective setting increases the risk of later developing a first-ever myocardial infarction (MI) independently of other cardiovascular risk factors. We used a nested case-referent study design within the Northern Sweden Health and Disease Study, and 545 subjects (29.0% women) were identified who prospectively developed a first-ever MI, and their 1054 matched referents. For women, but not for men, one standard deviation (SD) increase of ln z -scores of eGFR cystatin C /eGFR creatinine ratio was associated with a lower risk of a future MI: odds ratio [95% confidence interval] 0.58 [0.34–0.99], adjusted for apolipoprotein B/A1 ratio, CRP, homocysteine, systolic blood pressure, body mass index, and diabetes. Furthermore, a high eGFR creatinine associated independently with an increased risk of future MI in men only: OR 1.25 [1.05–1.48]. Thus, for women, a lower eGFR cystatin C /eGFR creatinine ratio is associated with a higher risk of having a future first-ever MI, and it may be a valuable, easily implemented biomarker for risk of cardiovascular disease.