Cystatin C-Based eGFR Is a Superior Prognostic Parameter to Creatinine-Based eGFR in Post-Endovascular Therapy Peripheral Artery Disease Patients

Otaki, Yoichiro; Takahashi, Hiroki; Watanabe, Tetsu; Yamaura, Gensai; Funayama, Akira; Arimoto, Takanori; Shishido, Tetsuro; Miyamoto, Takuya

doi:10.1253/circj.cj-15-0762

Cited by 12 publications

(7 citation statements)

References 32 publications

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“…Therefore, we measured the cystatin C-based estimated glomerular filtration rate (eGFRcys) and creatinine-based eGFR (eGFRcr). [13][14][15] eGFRcr and eGFRcys were calculated as follows: eGFRcr in men=194×sCr −1.094 ×age −0.287 ; eGFRcr in women=194×sCr −1.094 ×age −0.287 ×0.739.…”

Section: Biochemical Markersmentioning

confidence: 99%

Impact of Objective Malnutrition Status on the Clinical Outcomes in Patients With Peripheral Artery Disease Following Endovascular Therapy

Yokoyama

Watanabe

Otaki

et al. 2018

Circ J

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Background: Peripheral artery disease (PAD) is an athero-occlusive disease and a known risk factor for cardiovascular events. The controlling nutritional status (CONUT) score and geriatric nutritional risk index (GNRI) are objective tools for evaluating malnutrition and are reportedly associated with poor clinical outcomes in patients with fatal diseases. However, the effect of malnutrition on the clinical outcomes in patients with PAD remains unclear. Methods and Results:We enrolled 357 patients with PAD who underwent endovascular therapy. Malnutrition was diagnosed by CONUT score and GNRI as in previous reports. During a median follow-up period of 1,071 days, there were 67 major adverse cardiovascular and leg events (MACLEs). The CONUT score-and GNRI-based malnutrition statuses were identified in 56% and 46% of the patients, respectively. Proportion of malnutrition increased with advancing Fontaine class. The multivariate Cox proportional hazard regression analysis demonstrated that both the CONUT score-and GNRI-based malnutrition status was an independent predictor of MACLEs. The Kaplan-Meier analysis demonstrated that the MACLE ratio increased with deteriorating malnutrition. Finally, the addition of the CONUT score or GNRI to the known risk factors significantly improved the net reclassification index and integrated discrimination index. Conclusions:Malnutrition was common and closely associated with the clinical outcomes in patients with PAD, indicating that it is a novel therapeutic target in the management of these patients. Methods Study PopulationThis was a prospective study of 357 patients who were admitted to hospital for first PAD treatment. PAD was diagnosed in accordance with the ankle-brachial index (ABI) and computed tomographic angiography findings. EVT was performed by experienced cardiologists according sarcopenia in patients with PAD.The aim of the present study was to reveal the clinical significance of malnutrition in patients with PAD. To clarify this, we focused on the CONUT score and examined (1) the prevalence of malnutrition, (2) effect of malnutrition on the clinical outcome, and (3) association between malnutrition and sarcopenia in patients with PAD.

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Section: Biochemical Markersmentioning

confidence: 99%

Impact of Objective Malnutrition Status on the Clinical Outcomes in Patients With Peripheral Artery Disease Following Endovascular Therapy

Yokoyama

Watanabe

Otaki

et al. 2018

Circ J

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“…Recent investigations revealed that ventricular remodeling is the basic mechanism involved in heart failure. The pathological changes in ventricular remodeling include extracellular matrix remodeling and myocardial remodeling [10,11]. A recent study revealed that the content of chromogranin A (CgA) was elevated in CHF patients after myocardial infarction, with correlation between CgA level and mortality.…”

Section: Discussionmentioning

confidence: 99%

Effect of serum cystatin C and chromogranin A on left ventricular mass index in patients with chronic heart failure

Xue¹,

Liu²

2019

Trop. J. Pharm Res

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Purpose: To investigate the expression of serum cystatin C (CystC) and chromogranin A (CgA) in chronic heart failure (CHF) patients, and their correlation with left ventricular mass index (LVMI). Methods: CHF patients (135) in the study hospital were randomly selected, and assigned to different groups on the basis of heart function grade (grades II to IV). Grades II, III and IV had 45 patients each. In addition, 45 people with normal physical examination results were assigned to the control group. In all patients, N-terminal natriuretic peptide (NT-proBNP), CysC and CgA were measured. In addition, left ventricular end-diastolic diameter (LVEDD), left ventricular end-diastolic volume (LVEDV), and left ventricular ejection fraction (LVEF) were measured using transthoracic echocardiography, and the results were used to calculate LVMI values. Results: There were significantly higher levels of CystC and CgA in CHF patients than in control patients (p < 0. 05). In grade IV patients, CystC and CgA levels were higher than the corresponding levels in patients with cardiac function grades II and III, while their levels in grade III patients were higher than in grade II patients (p < 0.05). The results of correlation analysis indicated that serum CgA was positively correlated with serum CystC. Serum CgA and CystC levels in CHF patients were negatively correlated with LVEF, but positively correlated with NT-proBNP and LVMI levels. Conclusion: Serum CgA and CysC are correlated with cardiac function grade and ventricular remodeling in CHF patients. Thus, to some extent, these two indices can be used to measure the degree of ventricular remodeling in CHF individuals.

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“…CysC is produced by all nucleated cells and is seemingly unaltered in inflammatory conditions ( 2 ). It is also less unaffected by age, sex ( 2 , 3 ), weight, and muscle mass ( 2 , 11 ) (although only after adjustment for BSA) ( 12 ).…”

Section: Cysc—a More Robust Measure?mentioning

confidence: 99%

Commentary: Renal Function Estimation and Cockcroft–Gault Formulas for Predicting Cardiovascular Mortality in Population-Based, Cardiovascular Risk, Heart Failure and Post-Myocardial Infarction Cohorts: The Heart ‘OMics’ in AGEing (HOMAGE) and the High-Risk Myocardial Infarction Database Initiatives

et al. 2017

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Cystatin C-Based eGFR Is a Superior Prognostic Parameter to Creatinine-Based eGFR in Post-Endovascular Therapy Peripheral Artery Disease Patients

Cited by 12 publications

References 32 publications

Impact of Objective Malnutrition Status on the Clinical Outcomes in Patients With Peripheral Artery Disease Following Endovascular Therapy

Impact of Objective Malnutrition Status on the Clinical Outcomes in Patients With Peripheral Artery Disease Following Endovascular Therapy

Effect of serum cystatin C and chromogranin A on left ventricular mass index in patients with chronic heart failure

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