Cystatin C and cardiovascular mortality in patients with coronary artery disease and normal or mildly reduced kidney function: results from the AtheroGene study
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Cystatin C and cardiovascular mortality in patients with coronary artery disease and normal or mildly reduced kidney function: results from the AtheroGene study. / Keller, Till; Messow, Claudia Martina; Lubos, Edith; Nicaud, Viviane; Wild, Philipp S; Rupprecht, Hans J; Bickel, Christoph; Tzikas, Stergios; Peetz, Dirk; Lackner, Karl J; Tiret, Laurence; Münzel, Thomas F; Blankenberg, Stefan; Schnabel, Renate B.
In: EUR HEART J, Vol. 30, No. 3, 02.2009, p. 314-320.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Cystatin C and cardiovascular mortality in patients with coronary artery disease and normal or mildly reduced kidney function: results from the AtheroGene study
AU - Keller, Till
AU - Messow, Claudia Martina
AU - Lubos, Edith
AU - Nicaud, Viviane
AU - Wild, Philipp S
AU - Rupprecht, Hans J
AU - Bickel, Christoph
AU - Tzikas, Stergios
AU - Peetz, Dirk
AU - Lackner, Karl J
AU - Tiret, Laurence
AU - Münzel, Thomas F
AU - Blankenberg, Stefan
AU - Schnabel, Renate B
PY - 2009/2
Y1 - 2009/2
N2 - AIMS: Chronic kidney disease is associated with increased risk of cardiovascular disease. Cystatin C is a promising marker to reliably mirror renal function. The role of cystatin C in patients with coronary artery disease (CAD) and normal or mildly reduced kidney function is the subject of current investigation.METHODS AND RESULTS: In 2162 patients, over the whole spectrum of CAD, baseline cystatin C concentrations were measured. Patients with an estimated glomerular filtration rate of < or =60 mL/min per 1.73 m(2) (n = 295) were excluded. In patients with complete follow-up information (n = 1827), 66 cardiovascular deaths were registered during a median follow-up of 3.65 years. Logarithmically transformed, standardized cystatin C was associated with cardiovascular death [hazard ratio: 1.94, 95% confidence interval (CI): 1.59-2.37, P < 0.001]. A potential threshold effect was observed; patients in the upper quartile had a 3.87-fold (95% CI: 2.33-6.42; P < 0.001) risk of mortality compared with the pooled lower quartiles. This risk association remained robust after adjustment for potential confounders including classical risk factors and N-terminal pro B-type natriuretic peptide. Serum creatinine was not associated with the outcome in this group of patients with normal renal function.CONCLUSION: Results of this prospective study show that cystatin C is a potent predictor of cardiovascular mortality beyond classical risk factors in patients with CAD and normal or mildly reduced kidney function.
AB - AIMS: Chronic kidney disease is associated with increased risk of cardiovascular disease. Cystatin C is a promising marker to reliably mirror renal function. The role of cystatin C in patients with coronary artery disease (CAD) and normal or mildly reduced kidney function is the subject of current investigation.METHODS AND RESULTS: In 2162 patients, over the whole spectrum of CAD, baseline cystatin C concentrations were measured. Patients with an estimated glomerular filtration rate of < or =60 mL/min per 1.73 m(2) (n = 295) were excluded. In patients with complete follow-up information (n = 1827), 66 cardiovascular deaths were registered during a median follow-up of 3.65 years. Logarithmically transformed, standardized cystatin C was associated with cardiovascular death [hazard ratio: 1.94, 95% confidence interval (CI): 1.59-2.37, P < 0.001]. A potential threshold effect was observed; patients in the upper quartile had a 3.87-fold (95% CI: 2.33-6.42; P < 0.001) risk of mortality compared with the pooled lower quartiles. This risk association remained robust after adjustment for potential confounders including classical risk factors and N-terminal pro B-type natriuretic peptide. Serum creatinine was not associated with the outcome in this group of patients with normal renal function.CONCLUSION: Results of this prospective study show that cystatin C is a potent predictor of cardiovascular mortality beyond classical risk factors in patients with CAD and normal or mildly reduced kidney function.
KW - Aged
KW - Biomarkers/blood
KW - Cardiovascular Diseases/blood
KW - Coronary Artery Disease/blood
KW - Cystatin C/blood
KW - Female
KW - Germany/epidemiology
KW - Humans
KW - Male
KW - Middle Aged
KW - Prognosis
KW - Prospective Studies
KW - Renal Insufficiency, Chronic/blood
U2 - 10.1093/eurheartj/ehn598
DO - 10.1093/eurheartj/ehn598
M3 - SCORING: Journal article
C2 - 19153178
VL - 30
SP - 314
EP - 320
JO - EUR HEART J
JF - EUR HEART J
SN - 0195-668X
IS - 3
ER -
