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Cystatin C concentration as a risk factor for heart failure in older adults.
Tuesday,2012-11-06 12:07 America/Los_Angeles — eenright
| Title | Cystatin C concentration as a risk factor for heart failure in older adults. |
| Publication Type | Journal Article |
| Year of Publication | 2005 |
| Authors | Sarnak, MJ, Katz, R, Stehman-Breen, CO, Fried, LF, Jenny, NSwords, Psaty, BM, Newman, AB, Siscovick, D, Shlipak, MG |
| Corporate/Institutional Authors | Cardiovascular Health Study, |
| Journal | Ann Intern Med |
| Volume | 142 |
| Issue | 7 |
| Pagination | 497-505 |
| Date Published | 2005 Apr 05 |
| ISSN | 1539-3704 |
| Keywords | Aged, Biomarkers, Creatinine, Cystatin C, Cystatins, Female, Follow-Up Studies, Glomerular Filtration Rate, Heart Failure, Humans, Incidence, Kidney, Kidney Function Tests, Male, Risk Factors, United States |
| Abstract | <p><b>BACKGROUND: </b>Previous studies that evaluated the association of kidney function with incident heart failure may be limited by the insensitivity of serum creatinine concentration for detecting abnormal kidney function.</p><p><b>OBJECTIVE: </b>To compare serum concentrations of cystatin C (a novel marker of kidney function) and creatinine as predictors of incident heart failure.</p><p><b>DESIGN: </b>Observational study based on measurement of serum cystatin C from frozen sera obtained at the 1992-1993 visit of the Cardiovascular Health Study. Follow-up occurred every 6 months.</p><p><b>SETTING: </b>Adults 65 years of age or older from 4 communities in the United States.</p><p><b>PARTICIPANTS: </b>4384 persons without previous heart failure who had measurements of serum cystatin C and serum creatinine.</p><p><b>MEASUREMENTS: </b>Incident heart failure.</p><p><b>RESULTS: </b>The mean (+/-SD) serum concentrations of cystatin C and creatinine were 82 +/- 25 nmol/L (1.10 +/- 0.33 mg/L) and 89 +/- 34 micromol/L (1.01 +/- 0.39 mg/dL), respectively. During a median follow-up of 8.3 years (maximum, 9.1 years), 763 (17%) participants developed heart failure. After adjustment for demographic factors, traditional and novel cardiovascular risk factors, cardiovascular disease status, and medication use, sequential quintiles of cystatin C concentration were associated with a stepwise increased risk for heart failure in Cox proportional hazards models (hazard ratios, 1.0 [reference], 1.30 [95% CI, 0.96 to 1.75], 1.44 [CI, 1.07 to 1.94], 1.58 [CI, 1.18 to 2.12], and 2.16 [CI, 1.61 to 2.91]). In contrast, quintiles of serum creatinine concentration were not associated with risk for heart failure in adjusted analysis (hazard ratios, 1.0 [reference], 0.77 [CI, 0.59 to 1.01], 0.85 [CI, 0.64 to 1.13], 0.97 [CI, 0.72 to 1.29], and 1.14 [CI, 0.87 to 1.49]).</p><p><b>LIMITATIONS: </b>The mechanism by which cystatin C concentration predicts risk for heart failure remains unclear.</p><p><b>CONCLUSIONS: </b>The cystatin C concentration is an independent risk factor for heart failure in older adults and appears to provide a better measure of risk assessment than the serum creatinine concentration. *For a full list of participating Cardiovascular Health Study investigators and institutions, see http://www.chs-nhlbi.org.</p> |
| DOI | 10.7326/0003-4819-142-7-200504050-00008 |
| Alternate Journal | Ann Intern Med |
| PubMed ID | 15809461 |
| Grant List | K23 DK67303 / DK / NIDDK NIH HHS / United States 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 HL073208-01 / HL / NHLBI NIH HHS / United States |