Clinical Report: Evaluation of Various eGFR Formulas in Predicting MACE

Overview

This study evaluates the predictive performance of creatinine-based versus cystatin C–based eGFR equations for 1-year major adverse cardiovascular events (MACE) in patients undergoing percutaneous coronary intervention (PCI) for acute coronary syndrome.

Background

Renal dysfunction is a significant risk factor for cardiovascular disease, particularly in patients with coronary artery disease. Accurate assessment of renal function is crucial for risk stratification in patients undergoing PCI, as it can influence clinical outcomes. This study aims to clarify the comparative effectiveness of different eGFR equations in predicting MACE following PCI.

Data Highlights

Key Findings

• Cystatin C–based eGFR equations classified more patients as having impaired renal function compared to creatinine-based formulas.
• Moderate-to-severe renal dysfunction defined by creatinine-based eGFR was linked to increased 1-year MACE risk.
• After multivariable adjustment, creatinine-based eGFR was not an independent predictor of MACE.
• Logistic regression demonstrated the highest discriminative ability for predicting MACE among the models tested.
• SHAP analysis highlighted cardiovascular functional parameters and metabolic markers as key contributors to risk prediction.

Clinical Implications

The findings indicate that both eGFR equations provide valuable information regarding renal function assessment in patients following PCI.

Conclusion

This study indicates that creatinine-based eGFR is associated with 1-year MACE following PCI compared to cystatin C–based eGFR. Further validation in larger cohorts is necessary.

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