***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES The goal of this study was to determine if restenosis is increased in mild and moderate chronic kidney disease ( CKD ) patients after percutaneous coronary intervention ( PCI ) .  BACKGROUND Mortality is increased in CKD after PCI  . Restenosis may contribute to increased late mortality . METHODS We analyzed 11,187 patients with a creatinine < 1.8 mg/dl from the Prevention of REStenosis with Tranilast and its Outcomes ( PRESTO ) trial , grouped by estimated creatinine clearance ( CrCl ) ( < 60 , 60 to 89 , > 89 ml/min ) . The Cox proportional hazards models investigated the association between CrCl group and death , myocardial infa rct ion , and target vessel revascularization ( TVR ) . Generalized estimating equation regression models determined the association between CrCl group and lesion-specific restenosis . RESULTS At 30 days , there was no difference in myocardial infa rct ion , death , or TVR between the CrCl groups . At nine months , mortality was higher in the lowest CrCl group ( 2.2 % , 1.2 % , 0.8 % ; p < 0.001 ) , which was no longer significant after adjusting for confounding variables . Myocardial infa rct ion and TVR were not different between the groups . In patients undergoing protocol follow-up angiography , restenosis ( > /=50 % ) was not increased with CKD ( 32 % , 32 % , 37 % ; p = 0.02 ) . CONCLUSIONS Mortality nine months after PCI is mildly increased in mild or moderate CKD patients . However , restenosis is not and does not account for the increased mortality Background —Persons with end-stage renal disease and those with lesser degrees of chronic kidney disease ( CKD ) have an increased risk of death after myocardial infa rct ion ( MI ) that is not fully explained by associated comorbidities . Future cardiovascular event rates and the relative response to therapy in persons with mild to moderate CKD are not well characterized . Methods and Results —We calculated the estimated glomerular filtration rate ( eGFR ) using the 4-variable Modification of Diet in Renal Disease method in 2183 Survival And Ventricular Enlargement ( SAVE ) trial subjects . SAVE r and omized post-MI subjects ( 3 to 16 days after MI ) with left ventricular ejection fraction ≤40 % and serum creatinine < 2.5 mg/dL to captopril or placebo .  Cox proportional hazards models were used to evaluate the relative hazard rates for death and cardiovascular events associated with reduced eGFR . Subjects with reduced eGFR were older and had more extensive comorbidities . The multivariable adjusted risk ratio for total mortality associated with reduced eGFR from 60 to 74 , 45 to 59 , and < 45 mL · min−1 · 1.73 m−2 ( compared with eGFR ≥75 mL · min−1 · 1.73 m−2 ) was 1.11 ( 0.86 to 1.42 ) , 1.24 ( 0.96 to 1.60 ) and 1.81 ( 1.32 to 2.48 ) , respectively ( P for trend = 0.001 ) . Similar adjusted trends were present for CV mortality ( P=0.001 ) , recurrent MI ( P=0.017 ) , and the combined CV mortality and morbidity outcome ( P=0.002 ) . The absolute benefit of captopril tended to be greater in subjects with CKD : 12.4 versus 5.5 CV events prevented per 100 subjects with ( n=719 ) and without ( n=1464 ) CKD , respectively . Conclusions —CKD was associated with a heightened risk for all major CV events after MI , particularly among subjects with an estimated glomerular filtration rate < 45 mL · min−1 · 1.73 m−2 . R and omization to captopril result ed in a reduction of CV events irrespective of baseline kidney function OBJECTIVES This study sought to determine the independent association of renal insufficiency with cardiovascular risk among women with known coronary heart disease ( CHD ) . BACKGROUND Although patients with end-stage renal disease and proteinuria are at high risk for cardiovascular events , little is known about the cardiovascular risk associated with moderate renal insufficiency . METHODS The Heart and Estrogen/progestin Replacement Study ( HERS ) was a clinical trial among 2,763 women with coronary disease who were r and omized to conjugated estrogen plus progestins or identical placebo and followed for a mean of 4.1 years . Women were categorized as having normal renal function ( creatinine < 1.2 mg/dl ; n = 2,012 ) , mild renal insufficiency ( 1.2 mg/dl to 1.4 mg/dl ; n = 567 ) and moderate renal insufficiency ( > 1.4 mg/dl ; n = 182 ) . We examined the independent association of renal function with incident cardiovascular events including CHD death , nonfatal myocardial infa rct ion , hospitalization for unstable angina , stroke and transient ischemic attacks . RESULTS Compared with women with normal renal function , those with mild and moderate renal insufficiency were older , more likely to be black , have a history of hypertension and diabetes and have higher serum levels of triglycerides and lipoprotein(a ) . After multivariate adjustment , both mild ( relative hazards [ RH ] = 1.24 ; 95 % confidence interval [ CI ] : 1.0 to 1.5 ) and moderate renal insufficiency ( RH = 1.57 ; 95 % CI : 1.2 to 2.1 ) were independently associated with increased risk for cardiovascular events compared with women with normal renal function . CONCLUSIONS Renal insufficiency is an independent risk factor for cardiovascular events in postmenopausal women with known coronary artery disease . Renal function may add helpful information to CHD risk stratification Background Reduced glomerular filtration rate ( GFR ) is associated with increased cardiovascular risk in young and middle aged individuals . Associations with cardiovascular disease and mortality in older people are less clearly established . We aim ed to determine the predictive value of the GFR for mortality and morbidity using data from the 5,804 participants r and omized in the Prospect i ve Study of Pravastatin in the Elderly at Risk ( PROSPER ) . Methods and Findings Glomerular filtration rate was estimated ( eGFR ) using the Modification of Diet in Renal Disease equation and was categorized in the ranges ( [ 20–40 ] , [ 40–50 ] , [ 50–60 ] ) ≥ 60 ml/min/1.73 m2 . Baseline risk factors were analysed by category of eGFR , with and without adjustment for other risk factors . The associations between baseline eGFR and morbidity and mortality outcomes , accrued after an average of 3.2 y , were investigated using Cox proportional hazard models adjusting for traditional risk factors . We tested for evidence of an interaction between the benefit of statin treatment and baseline eGFR status . Age , low-density lipoprotein ( LDL ) and high-density lipoprotein ( HDL ) cholesterol , C-reactive protein ( CRP ) , body mass index , fasting glucose , female sex , histories of hypertension and vascular disease were associated with eGFR ( p = 0.001 or less ) after adjustment for other risk factors . Low eGFR was independently associated with risk of all cause mortality , vascular mortality , and other noncancer mortality and with fatal and nonfatal coronary and heart failure events ( hazard ratios adjusted for CRP and other risk factors ( 95 % confidence intervals [ CIs ] ) for eGFR < 40 ml/min/1.73m2 relative to eGFR ≥ 60 ml/min/1.73m2 respectively 2.04 ( 1.48–2.80 ) , 2.37 ( 1.53–3.67 ) , 3.52 ( 1.78–6.96 ) , 1.64 ( 1.18–2.27 ) , 3.31 ( 2.03–5.41 ) . There were no nominally statistically significant interactions ( p < 0.05 ) between r and omized treatment allocation and eGFR for clinical outcomes , with the exception of the outcome of coronary heart disease death or nonfatal myocardial infa rct ion ( p = 0.021 ) , with the interaction suggesting increased benefit of statin treatment in subjects with impaired GFRs . Conclusions We have established that , in an elderly population over the age of 70 y , impaired GFR is associated with female sex , with presence of vascular disease , and with levels of other risk factors that would be associated with increased risk of vascular disease . Further , impaired GFR is independently associated with significant levels of increased risk of all cause mortality and fatal vascular events and with composite fatal and nonfatal coronary and heart failure outcomes . Our analyses of the benefits of statin treatment in relation to baseline GFR suggest that there is no reason to exclude elderly patients with impaired renal function from treatment with a statin OBJECTIVES In Incremental Decrease in Endpoints through Aggressive Lipid-lowering ( IDEAL ) , we compared cardiovascular outcomes in patients with and without chronic kidney disease ( CKD ) ( estimated glomerular filtration rate < 60 mL min(-1 ) 1.73 m(-2 ) ) and analysed relationships between lipoprotein components ( LC ) and major coronary events ( MCE ) and other cardiovascular ( CV ) events . DESIGN Exploratory analysis of CV endpoints in a r and omized trial comparing high dose of atorvastatin to usual dose of simvastatin on MCE . SETTING S Patients with CKD were compared with the non-CKD patients .  Cox regression models were used to study the relationships between on-treatment levels of LC and incident MCE . FINDINGS Chronic kidney disease was strongly associated with cardiovascular end-points including total mortality . In patients with CKD , a significant benefit of high dose atorvastatin treatment was found for any CV events , stroke and peripheral artery disease , but not for MCE . However , all cardiovascular end-points except stroke and CV mortality were reduced in the non-CKD group . Differential changes in LC or relationships to LC could not explain the different treatment outcomes in MCE in the two groups . INTERPRETATION Chronic kidney disease was a powerful risk factor for all cardiovascular end-points . The reason why the significant reductions achieved by high-dose statin treatment in most CV end-points in the non-CKD group were only in part matched by similar reductions in the CKD patients is not apparent . This difference did not result from differential changes in or relations to LC , but limited power may have increased the possibility of chance findings Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Objective To evaluate the association of kidney function with  cardiovascular disease and mortality among apparently healthy women . Design Prospect i ve cohort study . Setting Women ’s Health Study , United States . Participants 27 939 female health professionals aged ≥45 who were free of cardiovascular disease and other major disease and who provided a blood sample at study entry . Main outcome measures Time to cardiovascular disease ( non-fatal stroke , non-fatal myocardial infa rct ion , coronary revascularisation procedures , or death from cardiovascular cause ) , specific cardiovascular disease events , and all-cause mortality . End points were confirmed after review of medical records and death certificates . Results Glomerular filtration rate ( GFR ) was estimated with the abbreviated Modification of Diet in Renal Disease Study equation . At baseline , 1315 ( 4.7 % ) women had GFR < 60 ml/min/1.73 m2 . During 12 years of follow-up , 1199 incident cardiovascular disease events and 856 deaths ( 179 from cardiovascular disease ) occurred . Compared with women with GFR ≥90 ml/min/1.73 m2 , the multivariable adjusted hazard ratios for any first cardiovascular disease were 0.95 ( 95 % CI 0.83 to 1.08 ) , 0.84 ( 0.70 to 1.00 ) , and 1.00 ( 0.79 to 1.27 ) among women with GFR of 75 - 89.9 , 60 - 74.9 , and < 60 ml/min/1.73 m2 , respectively ; the equivalent hazard ratios for all cause mortality were 0.93 ( 0.79 to 1.09 ) , 1.03 ( 0.85 to 1.26 ) , and 1.09 ( 0.83 to 1.45 ) . Similar null findings were observed for myocardial infa rct ion , stroke , coronary revascularisation , and non-cardiovascular death . However , an increased risk of death from cardiovascular disease was found among women with GFR < 60 ml/min/1.73 m2 ( hazard ratio 1.68 
    Output:
    
Decreased baseline eGFR is independently associated with increased future myocardial infa rct ion , and the risk increases with advanced renal insufficiency .