Abstract
BACKGROUND-: Cystatin C (CyC) is more sensitive than serum creatinine (sCr) to rapidly detect acute changes in renal function. METHODS AND RESULTS-: We measured CyC together with sCr in 410 consecutive patients with chronic kidney disease undergoing either coronary and/or peripheral angiography and/or angioplasty. sCr was assessed at baseline and 24 and 48 hours after contrast media exposure. CyC was assessed at baseline and at 24 hours. Major adverse events (including death of any cause and dialysis) at 12 months were assessed. At 48 hours after contrast media exposure, contrast-induced acute kidney injury (defined as a sCr increase >0.3 mg/dL) occurred in 34 patients (8.2%). A CyC increase concentration >10% at 24 hours after contrast media exposure was detected in 87 patients (21.2%). This was the best CyC cutoff for the early identification of patients at risk for contrast-induced acute kidney injury (negative predictive value=100%; positive predictive value=39.1%). According to the defined cutoffs (that is, increase in CyC >0% and sCr >0.3 mg/dL), major adverse events occurred in 16 of 297 patients (5.4%) without any cutoffs satisfied (group 1), in 9 of 49 patients (18.4%) with only a CyC increase >10% (group 2), and in 9 of 31 patients (29%) with both cutoffs satisfied (group 3). By logistic regression analysis, the independent predictors of major adverse events at 1 year were group 2 (odds ratio=2.52; 95% confidence interval, 1.17 to 5.41; P=0.02), group 3 (odds ratio=4.45; 95% confidence interval, 1.72 to 11.54; P=0.002), and baseline glomerular filtration rate (odds ratio=0.91; 95% confidence interval, 0.88 to 0.95; P
| Original language | English |
|---|---|
| Pages (from-to) | 2117-2122 |
| Number of pages | 6 |
| Journal | Circulation |
| Volume | 121 |
| Issue number | 19 |
| DOIs | |
| Publication status | Published - May 18 2010 |
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Keywords
- Contrast media
- Kidney
- Prognosis
ASJC Scopus subject areas
- Physiology (medical)
- Cardiology and Cardiovascular Medicine
Cite this
Cystatin C and contrast-induced acute kidney injury. / Briguori, Carlo; Visconti, Gabriella; Rivera, Natalia V.; Focaccio, Amelia; Golia, Bruno; Giannone, Rosalia; Castaldo, Diletta; De Micco, Francesca; Ricciardelli, Bruno; Colombo, Antonio.
In: Circulation, Vol. 121, No. 19, 18.05.2010, p. 2117-2122.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Cystatin C and contrast-induced acute kidney injury
AU - Briguori, Carlo
AU - Visconti, Gabriella
AU - Rivera, Natalia V.
AU - Focaccio, Amelia
AU - Golia, Bruno
AU - Giannone, Rosalia
AU - Castaldo, Diletta
AU - De Micco, Francesca
AU - Ricciardelli, Bruno
AU - Colombo, Antonio
PY - 2010/5/18
Y1 - 2010/5/18
N2 - BACKGROUND-: Cystatin C (CyC) is more sensitive than serum creatinine (sCr) to rapidly detect acute changes in renal function. METHODS AND RESULTS-: We measured CyC together with sCr in 410 consecutive patients with chronic kidney disease undergoing either coronary and/or peripheral angiography and/or angioplasty. sCr was assessed at baseline and 24 and 48 hours after contrast media exposure. CyC was assessed at baseline and at 24 hours. Major adverse events (including death of any cause and dialysis) at 12 months were assessed. At 48 hours after contrast media exposure, contrast-induced acute kidney injury (defined as a sCr increase >0.3 mg/dL) occurred in 34 patients (8.2%). A CyC increase concentration >10% at 24 hours after contrast media exposure was detected in 87 patients (21.2%). This was the best CyC cutoff for the early identification of patients at risk for contrast-induced acute kidney injury (negative predictive value=100%; positive predictive value=39.1%). According to the defined cutoffs (that is, increase in CyC >0% and sCr >0.3 mg/dL), major adverse events occurred in 16 of 297 patients (5.4%) without any cutoffs satisfied (group 1), in 9 of 49 patients (18.4%) with only a CyC increase >10% (group 2), and in 9 of 31 patients (29%) with both cutoffs satisfied (group 3). By logistic regression analysis, the independent predictors of major adverse events at 1 year were group 2 (odds ratio=2.52; 95% confidence interval, 1.17 to 5.41; P=0.02), group 3 (odds ratio=4.45; 95% confidence interval, 1.72 to 11.54; P=0.002), and baseline glomerular filtration rate (odds ratio=0.91; 95% confidence interval, 0.88 to 0.95; P
AB - BACKGROUND-: Cystatin C (CyC) is more sensitive than serum creatinine (sCr) to rapidly detect acute changes in renal function. METHODS AND RESULTS-: We measured CyC together with sCr in 410 consecutive patients with chronic kidney disease undergoing either coronary and/or peripheral angiography and/or angioplasty. sCr was assessed at baseline and 24 and 48 hours after contrast media exposure. CyC was assessed at baseline and at 24 hours. Major adverse events (including death of any cause and dialysis) at 12 months were assessed. At 48 hours after contrast media exposure, contrast-induced acute kidney injury (defined as a sCr increase >0.3 mg/dL) occurred in 34 patients (8.2%). A CyC increase concentration >10% at 24 hours after contrast media exposure was detected in 87 patients (21.2%). This was the best CyC cutoff for the early identification of patients at risk for contrast-induced acute kidney injury (negative predictive value=100%; positive predictive value=39.1%). According to the defined cutoffs (that is, increase in CyC >0% and sCr >0.3 mg/dL), major adverse events occurred in 16 of 297 patients (5.4%) without any cutoffs satisfied (group 1), in 9 of 49 patients (18.4%) with only a CyC increase >10% (group 2), and in 9 of 31 patients (29%) with both cutoffs satisfied (group 3). By logistic regression analysis, the independent predictors of major adverse events at 1 year were group 2 (odds ratio=2.52; 95% confidence interval, 1.17 to 5.41; P=0.02), group 3 (odds ratio=4.45; 95% confidence interval, 1.72 to 11.54; P=0.002), and baseline glomerular filtration rate (odds ratio=0.91; 95% confidence interval, 0.88 to 0.95; P
KW - Contrast media
KW - Kidney
KW - Prognosis
UR - http://www.scopus.com/inward/record.url?scp=77953125953&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77953125953&partnerID=8YFLogxK
U2 - 10.1161/CIRCULATIONAHA.109.919639
DO - 10.1161/CIRCULATIONAHA.109.919639
M3 - Article
C2 - 20439784
AN - SCOPUS:77953125953
VL - 121
SP - 2117
EP - 2122
JO - Circulation
JF - Circulation
SN - 0009-7322
IS - 19
ER -