ESC and ERA ask for a kidney test at every cardiovascular diagnosis
The European Society of Cardiology and European Renal Association ask for glomerular filtration rate and urine albumin-to-creatinine tests at every cardiovascular diagnosis. About 100 million people in Europe have chronic kidney disease. Guidance starts SGLT2 and renin-angiotensin inhibitors early, alongside statins. Nelson Wang finds only 2 per cent of patients receive four-pillar heart failure treatment; clinicians hold off fearing kidney function. CorCal Outcomes, calcium scoring and risk equations left major events at 2.7 per cent, adherence at 62 per cent against 23 per cent.
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Diagnosis now carries a filtration-rate and albumin-to-creatinine test
A joint guideline from the European Society of Cardiology and the European Renal Association recommends that everyone diagnosed with cardiovascular disease be tested with an estimated glomerular filtration rate from blood creatinine and a urine albumin-to-creatinine ratio. About 100 million people in Europe have chronic kidney disease, and all of them carry a raised risk of cardiovascular disease. The document gathers the sequence from screening to service planning under the acronym STAMP on CKD: screen, triage, address kidney risk, modify cardiovascular management, plan health services. Kevin Damman and William Herrington chaired the task force. The document is a consensus set of recommendations. It does not present a new trial result.[1]
SGLT2 and renin-angiotensin drugs sit early, while four-pillar uptake is 2 per cent
The document puts early use of renin-angiotensin system inhibitors and SGLT2 inhibitors alongside statin-based therapy at the centre. Nelson Wang's team at The George Institute for Global Health, with Brigham and Women's Hospital, built a tool that estimates how much each of the four recommended drug classes lowers risk for an individual patient, from pooled individual patient data in heart failure trials. Only 2 per cent of eligible patients currently receive the full four-pillar treatment. Wang said fear of low blood pressure, worsening kidney function and high potassium is the main reason clinicians hold off. About 64 million people live with heart failure worldwide, and one-year mortality risk reaches 30 per cent. Because the tool was built from trial populations, the team notes the estimates may not generalise fully to broader groups of patients.[1], [2]
Calcium scoring and risk equations left events at 2.7 per cent, while adherence split
Intermountain Health Care followed a cohort with no known atherosclerotic disease, no diabetes and no prior statin use, with statin guidance based either on a coronary artery calcium score or on the pooled cohort equations. Over 4.2 years major cardiovascular events stayed at 2.7 per cent in both arms and the noninferiority criterion was not met. The equations arm received a statin recommendation more than three times as often as the calcium arm, yet patients advised on the basis of a calcium score stuck with the drug at 62 per cent against 23 per cent. Mean age was 64 and 51 per cent were women. Joseph B Muhlestein said lower-than-expected event rates reduced the study's power to detect a difference and that noninferiority between the groups was not demonstrated. The 2025 focused update to the ESC and EAS dyslipidaemia guidelines already recommends that a raised calcium score, where measured, be considered a risk modifier in people at moderate risk or near treatment thresholds.[3]
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