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Cystatin-C and mortality in elderly persons with heart failure.
Tuesday,2012-11-06 12:07 America/Los_Angeles — eenright
| Title | Cystatin-C and mortality in elderly persons with heart failure. |
| Publication Type | Journal Article |
| Year of Publication | 2005 |
| Authors | Shlipak, MG, Katz, R, Fried, LF, Jenny, NSwords, Stehman-Breen, CO, Newman, AB, Siscovick, D, Psaty, BM, Sarnak, MJ |
| Journal | J Am Coll Cardiol |
| Volume | 45 |
| Issue | 2 |
| Pagination | 268-71 |
| Date Published | 2005 Jan 18 |
| ISSN | 0735-1097 |
| Keywords | Age Factors, Aged, Aged, 80 and over, Creatinine, Cystatin C, Cystatins, Female, Follow-Up Studies, Glomerular Filtration Rate, Heart Failure, Humans, Male, Pilot Projects, Predictive Value of Tests, Risk Assessment, Survival Analysis |
| Abstract | <p><b>OBJECTIVES: </b>We sought to evaluate cystatin-C, a novel measure of renal function, as a predictor of mortality in elderly persons with heart failure (HF) and to compare it with creatinine.</p><p><b>BACKGROUND: </b>Renal function is an important prognostic factor in patients with HF, but creatinine levels, which partly reflect muscle mass, may be insensitive for detecting renal insufficiency.</p><p><b>METHODS: </b>A total of 279 Cardiovascular Health Study participants with prevalent HF and measures of serum cystatin-C and creatinine were followed for mortality outcomes over a median of 6.5 years.</p><p><b>RESULTS: </b>Median creatinine and cystatin-C levels were 1.05 mg/dl and 1.26 mg/l. Each standard deviation increase in cystatin-C (0.35 mg/l) was associated with a 31% greater adjusted mortality risk (95% confidence interval [CI] 20% to 43%, p < 0.001), whereas each standard deviation increase in creatinine (0.39 mg/dl) was associated with a 17% greater adjusted mortality risk (95% CI 1% to 36%, p = 0.04). When both measures were combined in a single adjusted model, cystatin-C remained associated with elevated mortality risk (hazard ratio 1.60, 95% CI 1.32 to 1.94), whereas creatinine levels appeared associated with lower risk (hazard ratio 0.73, 95% CI 0.57 to 0.95).</p><p><b>CONCLUSIONS: </b>Cystatin-C is a stronger predictor of mortality than creatinine in elderly persons with HF. If confirmed in future studies, this new marker of renal function could improve risk stratification in patients with HF.</p> |
| DOI | 10.1016/j.jacc.2004.09.061 |
| Alternate Journal | J Am Coll Cardiol |
| PubMed ID | 15653026 |
| Grant List | N01 HC 15103 / HC / NHLBI NIH HHS / United States N01 HC 35129 / HC / NHLBI NIH HHS / United States N01 HC 85079 / HC / NHLBI NIH HHS / United States N01 HC 85080 / HC / NHLBI NIH HHS / United States N01 HC 85081 / HC / NHLBI NIH HHS / United States N01 HC 85082 / HC / NHLBI NIH HHS / United States N01 HC 85083 / HC / NHLBI NIH HHS / United States N01 HC 85084 / HC / NHLBI NIH HHS / United States N01 HC 85085 / HC / NHLBI NIH HHS / United States N01 HC 85086 / HC / NHLBI NIH HHS / United States R01 HL 073208 / HL / NHLBI NIH HHS / United States |