Abstract
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.
| Original language | English |
|---|---|
| Pages (from-to) | 757-764 |
| Number of pages | 8 |
| Journal | EuroIntervention |
| Volume | 11 |
| Issue number | 7 |
| DOIs | |
| Publication status | Published - Nov 1 2015 |
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Keywords
- Coronary artery disease
- Cystatin C
- Estimated glomerular filtration rate
- Percutaneous transluminal coronary intervention
- Prognosis
- Receiver-operating characteristic curve analysis
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Cystatin C and risk of mortality among patients undergoing percutaneous coronary intervention. / 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.
In: EuroIntervention, Vol. 11, No. 7, 01.11.2015, p. 757-764.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Cystatin C and risk of mortality among patients undergoing percutaneous coronary intervention
AU - Angeli, Fabio
AU - Verdecchia, Paolo
AU - Savonitto, Stefano
AU - Arraiz, Gustavo
AU - Zaninotto, Martina
AU - Broccatelli, Andrea
AU - Cosma, Chiara
AU - De Servi, Stefano
AU - Sabino, Federico
AU - Briguori, Carlo
AU - Ambrosio, Giuseppe
AU - Cavallini, Claudio
PY - 2015/11/1
Y1 - 2015/11/1
N2 - 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.
AB - 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.
KW - Coronary artery disease
KW - Cystatin C
KW - Estimated glomerular filtration rate
KW - Percutaneous transluminal coronary intervention
KW - Prognosis
KW - Receiver-operating characteristic curve analysis
UR - http://www.scopus.com/inward/record.url?scp=84982085538&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84982085538&partnerID=8YFLogxK
U2 - 10.4244/EIJY15M05_08
DO - 10.4244/EIJY15M05_08
M3 - Article
VL - 11
SP - 757
EP - 764
JO - EuroIntervention
JF - EuroIntervention
SN - 1774-024X
IS - 7
ER -