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

BACKGROUND

Cystatin C, which has long been regarded as a biomarker that indicates kidney functions, has recently been recognized as an inflammatory marker in the human body.

AIM: To elucidate how cystatin C is related to the prognosis of systolic heart failure patients.

METHODS

Patients with systolic heart failure who were admitted to the fourth affiliated hospital of Harbin Medical University between January and April 2008 were enrolled in this study. Serum homocysteine, high-sensitivity C-reactive protein (hs-CRP) and cystatin C levels were determined and all the patients received an average of 2 years of follow-up for occurrence of death, heart transplantation or readmission with worsening heart failure.

RESULTS

Of 138 patients enrolled, those who experienced adverse outcomes (e.g. cardiac death, heart transplantation or progressive heart failure) (n = 21) had considerably higher mean levels of serum homocysteine (28.6 ± 13.4 vs 14.4 ± 6.3mg/L; P < 0.01), hs-CRP (17.5 ± 14.1 vs 6.4 ± 7.7 μmol/L; p < 0.01) and cystatin C (1.63 ± 0.81 vs 0.91 ± 0.27 mg/L; P < 0.01) than those without adverse outcomes (n = 117). Furthermore, the Cox proportional hazards model demonstrated that serum homocysteine, hs-CRP and cystatin C are all independent predictors of adverse outcomes.

CONCLUSIONS

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.