Plasma cystatin C for prediction of 1-year cardiac events in Mediterranean patients with non-ST elevation acute coronary syndrome

Taglieri, Nevio; Fernández-Bergés, Daniel; Köenig, Wolfgang; Consuegra-Sánchez, Luciano; Fernández, José María Cruz; Robles, Nicolás Roberto; Sánchez, Pedro L.; Beiras, Alfonso Castro; Orbe, Pedro María Montes; Kaski, Juan Carlos

doi:10.1016/j.atherosclerosis.2009.09.022

Cited by 55 publications

(38 citation statements)

References 36 publications

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“…Our final primary analysis included 18 articles derived from 14 independent prospective studies, 8,9,[27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] consisting of 22 509 participants. Among the 14 studies, 13 reported CVD outcomes (2321 events), 8,9,27,29,31-38,40 -42 4 reported CHD outcomes (741 events), 8,9,31,39 and 4 reported stroke outcomes (828 events).…”

Section: Resultsmentioning

confidence: 99%

Impact of Elevated Cystatin C Level on Cardiovascular Disease Risk in Predominantly High Cardiovascular Risk Populations

Lee

Saver

Huang

et al. 2010

Circ: Cardiovascular Quality and Outcomes

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Background-Chronic kidney disease is a growing public health problem that carries substantial risk for cardiovascular disease (CVD). Single studies have differentially examined the role of cystatin C, a novel renal index, with varying cut-point use. We undertook a meta-analysis of prospective studies to properly assess the link between cystatin C (dichotomized and continuous) versus CVD. Methods and Results-Systematic literature search for studies reporting a multivariate-adjusted estimate, represented as relative risk (RR) with 95% confidence interval (CI), of the association between cystatin C and subsequent risk of (1) any CVD event and (2)

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Section: Resultsmentioning

confidence: 99%

Impact of Elevated Cystatin C Level on Cardiovascular Disease Risk in Predominantly High Cardiovascular Risk Populations

Lee

Saver

Huang

et al. 2010

Circ: Cardiovascular Quality and Outcomes

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“…Increased levels of CysC were an independent predictor of cardiac events within a 1-y follow-up in this contemporary series of Mediterranean subjects with non-ST-elevation acute coronary syndrome. 11 The concentration of CysC was strongly associated with long-term all-cause and cardiovascular mortality in subjects referred for coronary angiography, irrespective of the renal function status based on creatinine measurements. 23 However, the literature describing the role of CysC in COPD is sparse, and few studies have addressed this issue to date.…”

Section: Discussionmentioning

confidence: 99%

“…8 Recent studies have revealed that CysC has a predictive and prognostic value in cardiovascular disease, especially coronary artery disease and heart failure. [9][10][11][12][13] However, the literature on the role of CysC in subjects with COPD exacerbation is sparse. One study that examined the level of CysC in COPD subjects showed that a high CysC concentration may be a potential indicator of impaired lung function and that routinely measuring CysC may improve the diagnosis and assessment of COPD severity in elderly male subjects.…”

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confidence: 99%

Cystatin C as a Predictor of In-Hospital Mortality After Exacerbation of COPD

Zhou

et al. 2016

Respir Care

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BACKGROUND: COPD is associated with cardiovascular and renal dysfunction. Cystatin C (CysC) is a biomarker of renal function and an independent risk factor for all-cause and cardiovascular mortality among elderly persons. The aim of the study was to examine the prognostic role of CysC for in-hospital mortality in subjects with a COPD exacerbation. METHODS: Upon admission, serum CysC levels and arterial blood gas analysis from 477 subjects with a COPD exacerbation were measured. Clinical characteristics were also recorded. A receiver operating characteristic curve analysis was used to determine the level of CysC that discriminated survivors from nonsurvivors. Univariate and multiple logistic regression analyses were used to identify the risk factors for in-hospital mortality. To reduce the influence of confounders, subgroup analyses were performed according to the comorbidities, including states of heart failure, renal dysfunction, and pH, P aCO 2 , and P aO 2 levels. RESULTS: During the in-hospital period, 59 subjects died, and 418 subjects recovered. The decedent group showed lower pH (7.27 ؎ 0.17 vs 7.38 ؎ 0.06, P < .001), higher CysC (2.21 ؎ 1.05 mg/L vs 1.39 ؎ 0.54 mg/L, P < .001), higher P aCO 2 (77 ؎ 39 mm Hg vs 48 ؎ 14 mm Hg, P < .001), and lower P aO 2 (74 ؎ 32 mm Hg vs 84 ؎ 26 mm Hg, P < .001) levels. The area under the receiver operating characteristic curve for the CysC prediction of death was 0.77 (95% CI 0.70 -0.84). CysC values >1.59 mg/L were associated with significantly higher inhospital mortality (relative risk ‫؍‬ 5.49, 95% CI 3.24 -9.32, P < .001). Multiple logistic regression analysis showed that pH <7.20, CysC >1.59 mg/L, and heart failure were independent predictors of in-hospital mortality. The subgroup analysis showed that the comorbid states of renal dysfunction, congestive heart failure, and the levels of pH, P aCO 2 , and P aO 2 did not alter the conclusion that CysC was a mortality risk factor for subjects with a COPD exacerbation. CONCLUSION: CysC was a strong and independent risk factor for hospital mortality secondary to COPD exacerbation.

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“…Increased levels of CysC were found to be an independent predictor of CV events (cardiac death, nonfatal MI or unstable angina) at 6-month to 1-year follow-up of patients with non-ST elevation ACS compared to highsensitivity C-reactive protein (CRP), B-type natriuretic peptide (BNP), and sCr. 36,37 CysC was also found to be the most valuable parameter compared to CRP, N-terminal proBNP, and troponin I in prediction of LV dysfunction progression in patients with a first STEMI. 38 Moreover, in a group of 240 patients admitted to the hospital with acute exacerbation of HF, CysC level was significantly associated with risk of death or rehospitalization during 1-year followup.…”

Section: Cysc In Acs and Congestive Hfmentioning

confidence: 99%

Early Biomarkers of Renal Injury

Cruz

Goh

Haase-Fielitz

et al. 2010

Congestive Heart Failure

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Congest Heart Fail. 2010;16(4)(suppl 1):S25–S31. ©2010 Wiley Periodicals, Inc.Cardiorenal syndrome (CRS) refers to pathophysiologic interaction of the heart and kidney and is associated with acute kidney injury (AKI) and high mortality. Cardiac surgery or acute decompensated heart failure and radiocontrast‐induced nephropathy are common clinical scenarios of CRS. Unfortunately, established functional biomarkers of glomerular filtration rate such as serum creatinine, urea, and diuresis delay AKI diagnosis by 24 to 48 hours. Novel renal biomarkers indicating tubular injury are emerging and may have wide implications. This review focuses on several novel renal biomarkers with the most promising biologic characteristics and clinical evidence for their AKI predictive ability: neutrophil gelatinase‐associated lipocalin, kidney injury molecule‐1, interleukin 18, and fatty acid–binding proteins. The value of each biomarker is reviewed on currently available clinical data in typical settings of CRS. These markers might extend the therapeutic window during which timely and individualized patient management might be possible.

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Plasma cystatin C for prediction of 1-year cardiac events in Mediterranean patients with non-ST elevation acute coronary syndrome

Cited by 55 publications

References 36 publications

Impact of Elevated Cystatin C Level on Cardiovascular Disease Risk in Predominantly High Cardiovascular Risk Populations

Impact of Elevated Cystatin C Level on Cardiovascular Disease Risk in Predominantly High Cardiovascular Risk Populations

Cystatin C as a Predictor of In-Hospital Mortality After Exacerbation of COPD

Early Biomarkers of Renal Injury

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