THURSDAY, March 6 (HealthDay News) -- In patients with acute coronary syndrome, the Cockcroft-Gault (C-G) formula is the preferred method of estimating kidney function to allow accurate dosing of antithrombotic medication, according to an article published in the March 11 issue of the Journal of the American College of Cardiology.
Chiara Melloni, M.D., of Duke University Medical Center in Durham, N.C., and colleagues compared the C-G and Modification of Diet in Renal Disease (MDRD) formulae for estimated glomerular filtration rate (eGFR) in 46,942 patients with non-ST-segment elevation acute coronary syndrome. The researchers calculated the proportion of patients who would require renal dose adjustments of glycoprotein IIb/IIIa inhibitors and low-molecular-weight heparin using each formula.
Median eGFRs were 53.2 mL/min with the C-G formula and 65.8 mL/min with the MDRD formula. Mean eGFR was higher with the MDRD formula, and the difference was magnified in smaller patients, women and the elderly. More patients required antithrombotic dose adjustment when C-G formula was used, compared to MDRD.
"Whereas MDRD and C-G formulae are highly correlated, their categorical estimations of chronic kidney disease differ in 20 percent of an acute coronary syndrome population," write the authors. "These differences translate into more antithrombotic dose adjustment by C-G and a lower risk of bleeding. Therefore, safety is enhanced by dosing based on C-G formula, particularly in the elderly, small, or female patients."
This research is partially funded by Schering-Plough Corp., Bristol-Myers, Squibb/Sanofi Pharmaceuticals Partnership and Millennium Pharmaceuticals, Inc.
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