Web of Science: 9 citations, Scopus: 10 citations, Google Scholar: citations,
Limited Value of Cystatin-C over Estimated Glomerular Filtration Rate for Heart Failure Risk Stratification
Zamora Serrallonga, Elisabet (Hospital Germans Trias i Pujol)
Lupón, Josep (Hospital Germans Trias i Pujol)
Antonio, Marta de (Hospital Germans Trias i Pujol)
Vila, Joan (Hospital del Mar. Institut Municipal d’Investigació Mèdica)
Galán, Amparo (Hospital Germans Trias i Pujol)
Gastelurrutia, Paloma (Hospital Germans Trias i Pujol)
Urrutia de Diego, Agustín (Hospital Germans Trias i Pujol)
Bayés Genís, Antoni (Hospital Germans Trias i Pujol)

Date: 2012
Abstract: Background: to compare the prognostic value of estimated glomerular filtration rate, cystatin-C, an alternative renal biomarker, and their combination, in an outpatient population with heart failure. Estimated glomerular filtration rate is routinely used to assess renal function in heart failure patients. We recently demonstrated that the Cockroft-Gault formula is the best among the most commonly used estimated glomerular filtration rate formulas for predicting heart failure prognosis. Methodology: a total of 879 consecutive patients (72% men, age 70. 4 years [P25–75 60. 5–77. 2]) were studied. The etiology of heart failure was mainly ischemic heart disease (52. 7%). The left ventricular ejection fraction was 34% (P25–75 26–43%). Most patients were New York Heart Association class II (65. 8%) or III (25. 9%). During a median follow-up of 3. 46 years (P25–75 1. 85–5. 05), 312 deaths were recorded. In an adjusted model, estimated glomerular filtration rate and cystatin-C showed similar prognostic value according to the area under the curve (0. 763 and 0. 765, respectively). In Cox regression, the multivariable analysis hazard ratios were 0. 99 (95% CI: 0. 98–1, P = 0. 006) and 1. 14 (95% CI: 1. 02–1. 28, P = 0. 02) for estimated glomerular filtration rate and cystatin-C, respectively. Reclassification, assessed by the integration discrimination improvement and the net reclassification improvement indices, was poorer with cystatin-C (−0. 5 [−1. 0;−0. 1], P = 0. 024 and −4. 9 [−8. 8;−1. 0], P = 0. 013, respectively). The value of cystatin-C over estimated glomerular filtration rate for risk-stratification only emerged in patients with moderate renal dysfunction (eGFR 30–60 ml/min/1. 73 m2, chi-square 12. 9, P<0. 001). Conclusions: taken together, the results indicate that estimated glomerular filtration rate and cystatin-C have similar long-term predictive values in a real-life ambulatory heart failure population. Cystatin-C seems to offer improved prognostication in heart failure patients with moderate renal dysfunction.
Rights: Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original. Creative Commons
Language: Anglès.
Document: article ; recerca ; publishedVersion
Subject: Heart failure ; Glomerular filtration rate ; Creatinine ; Prognosis ; Renal system ; Biomarkers ; Etiology ; Diabetes mellitus
Published in: PLoS One, Vol. 7 Issue 12 (December 2012) , p. e51234, ISSN 1932-6203

DOI: 10.1371/journal.pone.0051234
PMID: 23240006


8 p, 264.7 KB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (scientific output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
Articles > Published articles

 Record created 2015-10-19, last modified 2018-10-28



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