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Cystatin C concentration as a predictor of systolic and diastolic heart failure.
Tuesday,2012-11-06 12:09 America/Los_Angeles — eenright
| Title | Cystatin C concentration as a predictor of systolic and diastolic heart failure. |
| Publication Type | Journal Article |
| Year of Publication | 2008 |
| Authors | Moran, A, Katz, R, Smith, NL, Fried, LF, Sarnak, MJ, Seliger, SL, Psaty, B, Siscovick, DS, Gottdiener, JS, Shlipak, MG |
| Journal | J Card Fail |
| Volume | 14 |
| Issue | 1 |
| Pagination | 19-26 |
| Date Published | 2008 Feb |
| ISSN | 1532-8414 |
| Keywords | Aged, Aged, 80 and over, Biomarkers, Cohort Studies, Confidence Intervals, Cystatin C, Cystatins, Echocardiography, Female, Heart Failure, Diastolic, Heart Failure, Systolic, Humans, Longitudinal Studies, Male, Predictive Value of Tests, Probability, Proportional Hazards Models, Risk Assessment, Sensitivity and Specificity, Stroke Volume, Survival Analysis |
| Abstract | <p><b>BACKGROUND: </b>Risk factors for heart failure (HF) may differ according to ejection fraction (EF). Higher cystatin C, a marker of kidney dysfunction, is associated with incident HF, but previous studies did not determine EF at diagnosis. We hypothesized that kidney dysfunction would predict diastolic HF (DHF) better than systolic HF (SHF) in the Cardiovascular Health Study.</p><p><b>METHODS AND RESULTS: </b>Cystatin C was measured in 4453 participants without HF at baseline. Incident HF was categorized as DHF (EF > or = 50%) or SHF (EF < 50%). We compared the association of cystatin C with the risk for DHF and SHF, after adjustment for age, sex, race, medications, and HF risk factors. During 8 years of follow-up, 167 participants developed DHF and 206 participants developed SHF. After adjustment, sequentially higher quartiles of cystatin C were associated with risk for SHF (competing risks hazard ratios 1.0 [reference], 1.99 [95% confidence interval 1.14-3.48], 2.32 [1.32-4.07], 3.17 [1.82-5.50], P for trend < .001). The risk for DHF was apparent only at the highest cystatin C quartile (hazard ratios 1.0 [reference], 1.09 [0.62-1.89], 1.08 [0.61-1.93], and 1.83 [1.07-3.11]).</p><p><b>CONCLUSIONS: </b>Cystatin C levels are linearly associated with the incidence of systolic HF, whereas only the highest concentrations of cystatin C predict diastolic HF.</p> |
| DOI | 10.1016/j.cardfail.2007.09.002 |
| Alternate Journal | J Card Fail |
| PubMed ID | 18226769 |
| PubMed Central ID | PMC2258307 |
| Grant List | R01 DK066488-04 / DK / NIDDK NIH HHS / United States N01 HC015103 / HC / NHLBI NIH HHS / United States R01 DK066488 / DK / NIDDK NIH HHS / United States N01-HC-75150 / HC / NHLBI NIH HHS / United States N01HC75150 / HL / NHLBI NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States N01 HC045133 / HC / NHLBI NIH HHS / United States N01 HC035129 / HC / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States |