Cystatin C levels are associated with the prognosis of systolic heart failure patients

Gao, C Y; Zhong, Liang; Gao, Yanhui; Li, Xueqi; Zhang, Mingyu; Wei, Shipeng

doi:10.1016/j.acvd.2011.08.003

Cited by 24 publications

(24 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Interestingly, Naruse et al[28] found the best relationship between high levels of cystatin-C and the risk of cardiac death in patients with acute HF and an eGFR calculated by the MDRD formula between 44 and 79 ml/min/1.73 m 2 , independent of volemia and body weight. Cystatin-C was also an independent predictor of prognosis at 2 years of follow-up for the occurrence of death, heart transplantation, or readmission due to worsening HF in 138 systolic HF patients admitted for acute descompensation [29].…”

Section: Discussionmentioning

confidence: 95%

Limited Value of Cystatin-C over Estimated Glomerular Filtration Rate for Heart Failure Risk Stratification

et al. 2012

View full text Add to dashboard Cite

BackgroundTo compare the prognostic value of estimated glomerular filtration rate, cystatin-C, an alternative renal biomarker, and their combination, in an outpatient population with heart failure.Estimated glomerular filtration rate is routinely used to assess renal function in heart failure patients. We recently demonstrated that the Cockroft-Gault formula is the best among the most commonly used estimated glomerular filtration rate formulas for predicting heart failure prognosis.Methodology/Principal FindingsA total of 879 consecutive patients (72% men, age 70.4 years [P25–75 60.5–77.2]) were studied. The etiology of heart failure was mainly ischemic heart disease (52.7%). The left ventricular ejection fraction was 34% (P25–75 26–43%). Most patients were New York Heart Association class II (65.8%) or III (25.9%). During a median follow-up of 3.46 years (P25–75 1.85–5.05), 312 deaths were recorded. In an adjusted model, estimated glomerular filtration rate and cystatin-C showed similar prognostic value according to the area under the curve (0.763 and 0.765, respectively). In Cox regression, the multivariable analysis hazard ratios were 0.99 (95% CI: 0.98–1, P = 0.006) and 1.14 (95% CI: 1.02–1.28, P = 0.02) for estimated glomerular filtration rate and cystatin-C, respectively. Reclassification, assessed by the integration discrimination improvement and the net reclassification improvement indices, was poorer with cystatin-C (−0.5 [−1.0;−0.1], P = 0.024 and −4.9 [−8.8;−1.0], P = 0.013, respectively). The value of cystatin-C over estimated glomerular filtration rate for risk-stratification only emerged in patients with moderate renal dysfunction (eGFR 30–60 ml/min/1.73 m2, chi-square 12.9, P<0.001).Conclusions/SignificanceTaken together, the results indicate that estimated glomerular filtration rate and cystatin-C have similar long-term predictive values in a real-life ambulatory heart failure population. Cystatin-C seems to offer improved prognostication in heart failure patients with moderate renal dysfunction.

show abstract

Section: Discussionmentioning

confidence: 95%

Limited Value of Cystatin-C over Estimated Glomerular Filtration Rate for Heart Failure Risk Stratification

et al. 2012

View full text Add to dashboard Cite

show abstract

“…This protein has a low molecular weight and does not form a complex with other secreted proteins in the blood [28]. Cystatin-C independently predicts adverse events in chronic HF and is also an independent risk factor in the prognosis of patients with HF [29]. Shlipak et al [30] showed the prognostic value of cystatin-C instable HF patients who had lower EF < 35%.…”

Section: Discussionmentioning

confidence: 99%

Effects of ivabradine therapy on heart failure biomarkers

et al. 2015

View full text Add to dashboard Cite

Background: Heart rate (HR) reduction is associated with improved outcomes in patients with heart failure (HF) and biomarkers can be a valuable diagnostic tool in HF management. The primary aim of our study was to evaluate the short-term (6 months) effect of ivabradine on N-terminal pro B-type natriuretic peptide (NT-proBNP), CA-125, and cystatin-C values in systolic HF outpatients, and secondary aim was to determine the relationship between baseline HR and the and , and cystatin-C were taken at baseline and at the end of a 6-month follow-up in both groups. Results: There was a significant decrease in NYHA class in the ivabradine group (2.67 ± ± 0.47 vs. 1.85 ± 0.61, p < 0.001). When ivabradine and control groups were compared, a significant difference was also found in NHYA class 6 months later (p = 0.013). A significant decrease was found in HR in the ivabradine and control groups (84.10 ± 8.76 vs. 68.36 ± ± 8.32 bpm, p = 0.001; 84.51 ± 10 vs. 80.40 ± 8.3 p < 0.001),353.02 ± 1,453.77 vs. 717.81 ± 834.76 pg/mL, p < 0.001) in the ivabradine group. When ivabradine and control groups were compared after 6 months, a significant decrease was found in all HF parameters (respectively;. Creatinine level was significantly decreased and glomerular filtration rate (GFR) was significantly increased in the ivabradine group (1.02 ± 0.26 vs. 0.86 ± 0.17, creatinine: p = 0.001; 79.26 Cardiology Journal 2015, Vol. 22, No. 5, 501-509 DOI: 10.5603/CJ.a2015.0012 Copyright © 2015 Via Medica ISSN 1897 , and cystatin-C may prove to be useful in biomarker panels evaluating ivabradine therapy response in HF patients. (Cardiol J 2015; 22, 5: 501-509) bpm, p = 0.001). When both groups were compared, a significant difference was also found in HR after 6 months (p = 0.001). A significant decrease was found in cystatin-C (2.10 ± 0.73 vs. 1.50 ± 0.44 mg/L, p < 0.001),

show abstract

“…Multiple small clinical studies have demonstrated that blood homocysteine levels are elevated in patients with heart failure compared to control population [81,82,83,84]. Blood homocysteine level is also related to the clinical severity of heart failure [85].…”

Section: Methionine-homocysteine Cycle Folate Metabolism and Heamentioning

confidence: 99%

Methoxistasis: Integrating the Roles of Homocysteine and Folic Acid in Cardiovascular Pathobiology

Joseph

Loscalzo

2013

Nutrients

View full text Add to dashboard Cite

Over the last four decades, abnormalities in the methionine-homocysteine cycle and associated folate metabolism have garnered great interest due to the reported link between hyperhomocysteinemia and human pathology, especially atherothrombotic cardiovascular disease. However, clinical trials of B-vitamin supplementation including high doses of folic acid have not demonstrated any benefit in preventing or treating cardiovascular disease. In addition to the fact that these clinical trials may have been shorter in duration than appropriate for modulating chronic disease states, it is likely that reduction of the blood homocysteine level may be an oversimplified approach to a complex biologic perturbation. The methionine-homocysteine cycle and folate metabolism regulate redox and methylation reactions and are, in turn, regulated by redox and methylation status. Under normal conditions, a normal redox-methylation balance, or “methoxistasis”, exists, coordinated by the methionine-homocysteine cycle. An abnormal homocysteine level seen in pathologic states may reflect a disturbance of methoxistasis. We propose that future research should be targeted at estimating the deviation from methoxistasis and how best to restore it. This approach could lead to significant advances in preventing and treating cardiovascular diseases, including heart failure.

show abstract

Cystatin C levels are associated with the prognosis of systolic heart failure patients

Abstract: Cystatin C, together with hs-CRP and homocysteine, is an independent risk factor that is important in the prognosis of patients with systolic heart failure.

Cited by 24 publications

References 27 publications

Limited Value of Cystatin-C over Estimated Glomerular Filtration Rate for Heart Failure Risk Stratification

Limited Value of Cystatin-C over Estimated Glomerular Filtration Rate for Heart Failure Risk Stratification

Effects of ivabradine therapy on heart failure biomarkers

Methoxistasis: Integrating the Roles of Homocysteine and Folic Acid in Cardiovascular Pathobiology

Contact Info

Product

Resources

About