What is the risk of mortality/MI associated with decreasing estimated GFR in high-risk patients with AMI?
The Modification of Diet in Renal Disease equation was used in the VALIANT (Valsartan in Acute Myocardial Infarction) trial to analyze 14527 high-risk patients with AMI with LV dysfunction or HF and a serum creatinine level 1.5 mg/dL. The analysis showed an increasing adjusted HR for both death and the composite endpoint of cardiovascular death, reinfarction, HF, stroke, or resuscitation after cardiac arrest with decreasing estimated GFR. For death, with a GFR <45.0 mL per minute/1.73 m2, the adjusted HR was 1.70 compared with patients with a GFR in whom the adjusted HR was 1.14. 