EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2015
Cystatin C and risk of mortality among patients undergoing percutaneous coronary intervention.
Сравнительное исследованиеСтатьяМногоцентровое исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Angeli Fabio, Verdecchia Paolo, Savonitto Stefano, Arraiz Gustavo, Zaninotto Martina, Broccatelli Andrea, Cosma Chiara, De Servi Stefano, Sabino Federico, Briguori Carlo, Ambrosio Giuseppe, Cavallini Claudio, Italian “Atherosclerosis, Thrombosis and Vascular Biology” and “Society for Invasive Cardiology-GISE” Investigators
Аннотация
AIMS: We tested the prognostic value of cystatin C in patients with documented coronary artery disease (CAD) who underwent percutaneous coronary artery intervention (PCI). We also tested the hypothesis that the incremental predictive value of cystatin C on all-cause mortality was superior to that of glomerular filtration rate (GFR) by the Modification of Diet in Renal Disease (MDRD) formula.
METHODS AND RESULTS: Included in the study were 2,757 patients (mean age 63 years, 77% men). Blood samples for cystatin C levels were collected immediately before PCI. During a median follow-up of two years, 114 patients died. In multivariable Cox analyses, after adjustment for several confounders, GFR (p=0.004) and cystatin C concentration (p<0.0001) were independent predictors of all-cause death. Cystatin C predicted all-cause death (c-statistic: 0.794) better than GFR estimate based on creatinine (c-statistic: 0.776, p=0.008 for comparison), and significantly reclassified 15% of patients into categories that reflected their actual likelihood of death more accurately (p=0.005). Adding cystatin C and GFR in the same multivariable survival model, only cystatin C level was a significant predictor of death.
CONCLUSIONS: This study presents for the first time the incremental predictive value of cystatin C over the creatinine-based MDRD formula on all-cause mortality for CAD patients undergoing PCI.
METHODS AND RESULTS: Included in the study were 2,757 patients (mean age 63 years, 77% men). Blood samples for cystatin C levels were collected immediately before PCI. During a median follow-up of two years, 114 patients died. In multivariable Cox analyses, after adjustment for several confounders, GFR (p=0.004) and cystatin C concentration (p<0.0001) were independent predictors of all-cause death. Cystatin C predicted all-cause death (c-statistic: 0.794) better than GFR estimate based on creatinine (c-statistic: 0.776, p=0.008 for comparison), and significantly reclassified 15% of patients into categories that reflected their actual likelihood of death more accurately (p=0.005). Adding cystatin C and GFR in the same multivariable survival model, only cystatin C level was a significant predictor of death.
CONCLUSIONS: This study presents for the first time the incremental predictive value of cystatin C over the creatinine-based MDRD formula on all-cause mortality for CAD patients undergoing PCI.
Предметные рубрики MeSH
Acute Coronary SyndromeAgedAngina, StableBiomarkersCreatinineCystatin CFemaleGlomerular Filtration RateHumansItalyKidney DiseasesMaleMiddle AgedModels, BiologicalMultivariate AnalysisPercutaneous Coronary InterventionPredictive Value of TestsProportional Hazards ModelsProspective StudiesRisk AssessmentRisk FactorsTime FactorsTreatment Outcome