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Diagnostic and prognostic value of cystatin C in acute heart failure.

Abstract：

BACKGROUND:The accurate early diagnosis of acute kidney injury (AKI) in patients with acute heart failure (AHF) is an unmet clinical need. Cystatin C might improve the early detection of AKI. METHODS:207 patients presenting to the emergency department with AHF were enrolled. Cystatin C was measured in plasma in a blinded fashion at presentation and serially thereafter. The potential of Cystatin C levels to predict AKI was assessed as the primary endpoint. Long-term mortality was assessed as a secondary endpoint. RESULTS:At presentation, creatinine (140μmol/L [91-203] vs. 97μmol/L [76-132], p<0.01) and Cystatin C (2.00mg/L [1.30-3.08] vs. 1.45mg/L [1.00-1.90], p<0.01) levels were significantly higher in AKI compared to Non-AKI patients. The diagnostic accuracy for AKI quantified by the area under the receiver operating characteristic curve was mediocre and comparable for both markers (creatinine 0.68; 95%CI 0.58-78 vs. Cystatin C 0.67; 95%CI 0.58-0.76). Serial measurements of Cystatin C did not further increase the prognostic accuracy for AKI. Cystatin C levels were significantly higher in decedents than in survivors (1.90mg/L [1.30-2.70] vs. 1.30mg/L [1.0-1.6], p<0.001). The combination of Cystatin C and BNP levels significantly improved the prediction of mortality provided by either parameter alone. In multivariable regression analysis Cystatin C remained independently associated with mortality (HR 1.41; 95%CI 1.02-1.95). CONCLUSION:Plasma Cystatin C levels do not adequately predict AKI in patients with AHF. However, in multivariable regression analysis Cystatin C predicted mortality after the adjustment for baseline renal function, AKI, BNP levels and heart failure risk factors.

journal_name

Clin Biochem

journal_title

Clinical biochemistry

authors

Breidthardt T,Sabti Z,Ziller R,Rassouli F,Twerenbold R,Kozhuharov N,Gayat E,Shrestha S,Barata S,Badertscher P,Boeddinghaus J,Nestelberger T,Mueller C

doi

10.1016/j.clinbiochem.2017.07.016

subject

Has Abstract

pub_date

2017-12-01 00:00:00

pages

1007-1013

issue

18

eissn

0009-9120

issn

1873-2933

pii

S0009-9120(17)30362-4

journal_volume

50

pub_type

杂志文章

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