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Cystatin C in acute heart failure without advanced renal impairment.
Am J Med. 2009 Jun; 122(6):566-73.AJ

Abstract

BACKGROUND

The prognostic value of cystatin C relative to glomerular filtration rate (GFR) estimated by the Modification of Diet in Renal Disease Study (MDRD) equation modified for Japan has not been investigated in acute heart failure patients with normal to moderately impaired renal function. More accurate detection of mild renal impairment might improve the risk stratification of heart failure patients, especially patients with normal to moderately impaired renal function.

METHODS

Cystatin C and creatinine levels were measured on admission in 328 consecutive patients hospitalized for worsening chronic heart failure with a GFR estimated by MDRD equation modified for Japan >or=30 mL/min/1.73 m(2).

RESULTS

During a median follow-up period of 915 days, there were 52 (16%) cardiac deaths. In stepwise Cox regression analyses including cystatin C and GFR estimated by MDRD equation modified for Japan (either as continuous variables or as variables categorized into quartiles), cystatin C (P <.0001), but not GFR estimated by MDRD equation modified for Japan, was independently associated with cardiac mortality. Adjusted relative risk according to the quartiles of these markers and Kaplan-Meier analyses revealed that the cystatin C was a better marker to separate low-risk from high-risk patients. Furthermore, receiver-operating characteristic curve analyses of these markers revealed that cystatin C showed a higher precision in predicting cardiac mortality.

CONCLUSION

Measurements of cystatin C might improve early risk stratification compared with GFR estimated by MDRD equation modified for Japan in acute heart failure patients with normal to moderately impaired renal function.

Authors+Show Affiliations

Department of Internal Medicine, Fujita Health University School of Medicine, Toyoake, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19393984

Citation

Naruse, Hiroyuki, et al. "Cystatin C in Acute Heart Failure Without Advanced Renal Impairment." The American Journal of Medicine, vol. 122, no. 6, 2009, pp. 566-73.
Naruse H, Ishii J, Kawai T, et al. Cystatin C in acute heart failure without advanced renal impairment. Am J Med. 2009;122(6):566-73.
Naruse, H., Ishii, J., Kawai, T., Hattori, K., Ishikawa, M., Okumura, M., Kan, S., Nakano, T., Matsui, S., Nomura, M., Hishida, H., & Ozaki, Y. (2009). Cystatin C in acute heart failure without advanced renal impairment. The American Journal of Medicine, 122(6), 566-73. https://doi.org/10.1016/j.amjmed.2008.10.042
Naruse H, et al. Cystatin C in Acute Heart Failure Without Advanced Renal Impairment. Am J Med. 2009;122(6):566-73. PubMed PMID: 19393984.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cystatin C in acute heart failure without advanced renal impairment. AU - Naruse,Hiroyuki, AU - Ishii,Junnichi, AU - Kawai,Tomoko, AU - Hattori,Kousuke, AU - Ishikawa,Makoto, AU - Okumura,Masanori, AU - Kan,Shino, AU - Nakano,Tadashi, AU - Matsui,Shigeru, AU - Nomura,Masanori, AU - Hishida,Hitoshi, AU - Ozaki,Yukio, Y1 - 2009/04/24/ PY - 2008/07/31/received PY - 2008/09/08/revised PY - 2008/10/14/accepted PY - 2009/4/28/entrez PY - 2009/4/28/pubmed PY - 2009/6/20/medline SP - 566 EP - 73 JF - The American journal of medicine JO - Am J Med VL - 122 IS - 6 N2 - BACKGROUND: The prognostic value of cystatin C relative to glomerular filtration rate (GFR) estimated by the Modification of Diet in Renal Disease Study (MDRD) equation modified for Japan has not been investigated in acute heart failure patients with normal to moderately impaired renal function. More accurate detection of mild renal impairment might improve the risk stratification of heart failure patients, especially patients with normal to moderately impaired renal function. METHODS: Cystatin C and creatinine levels were measured on admission in 328 consecutive patients hospitalized for worsening chronic heart failure with a GFR estimated by MDRD equation modified for Japan >or=30 mL/min/1.73 m(2). RESULTS: During a median follow-up period of 915 days, there were 52 (16%) cardiac deaths. In stepwise Cox regression analyses including cystatin C and GFR estimated by MDRD equation modified for Japan (either as continuous variables or as variables categorized into quartiles), cystatin C (P <.0001), but not GFR estimated by MDRD equation modified for Japan, was independently associated with cardiac mortality. Adjusted relative risk according to the quartiles of these markers and Kaplan-Meier analyses revealed that the cystatin C was a better marker to separate low-risk from high-risk patients. Furthermore, receiver-operating characteristic curve analyses of these markers revealed that cystatin C showed a higher precision in predicting cardiac mortality. CONCLUSION: Measurements of cystatin C might improve early risk stratification compared with GFR estimated by MDRD equation modified for Japan in acute heart failure patients with normal to moderately impaired renal function. SN - 1555-7162 UR - https://www.unboundmedicine.com/medline/citation/19393984/Cystatin_C_in_acute_heart_failure_without_advanced_renal_impairment_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9343(09)00102-8 DB - PRIME DP - Unbound Medicine ER -