16 February 2020 : Clinical Research
Association Between Cystatin C and Cardiac Function and Long-Term Prognosis in Patients with Chronic Heart FailureXilin Wu1ABCDEFG, Ge Xu2ABCDEFG, Shiming Zhang1ABCDEFG*
Med Sci Monit 2020; 26:e919422
BACKGROUND: The aim of this study was to investigate the association between cystatin C and cardiac function and long-term prognosis in patients with chronic heart failure (CHF).
MATERIAL AND METHODS: We selected 418 CHF patients admitted to our hospital as subjects. Patients were divided into 3 groups according to the cystatin C level (Quantile 1 group: 0.65–1.04 mg/L, Quantile 2 group: 1.05–1.35 mg/L, and Quantile 3 group: 1.36–7.84 mg/L), and patients were followed up for 5 years. We used odds ratio (OR) and 95% confidence interval (CI) to compare the results.
RESULTS: The cystatin C and NT-ProBNP level in the cardiac function grade (NYHA) class IV group were higher than those in the class III group (P<0.05). Pearson correlation analysis showed that there was a positive correlation between cystatin C and NT-ProBNP log₁₀ transform in CHF patients (r=0.411). During 5-year follow-up, 231 patients died and the 5-year all-cause mortality rate was 55.26% (231/418). There was a significant difference in 5-year all-cause mortality among the 3 groups (P for trend=0.010). After adjusting for potential confounders by multivariate regression analysis, the Quantile 2 group vs. Quantile 1 group were OR=0.83, 95% CI 0.51 to 1.35, P=0.448, and the Quantile 3 group vs. Quantile 1 group were OR=1.71, 95% CI. 1.04 to 2.82, P=0.034. Curve fitting showed that cystatin C was positively correlated with 5-year all-cause mortality in CHF patients.
CONCLUSIONS: Cystatin C was positively correlated with cardiac function and NT-ProBNP in CHF patients. Cystatin C could be used as a serological index to evaluate the long-term prognosis of CHF patients.
Keywords: cystatin C, Heart Failure, Mortality, Adolescent, Aged, biomarkers, Chronic Disease, Disease Progression, Follow-Up Studies, Heart, Middle Aged, Natriuretic Peptide, Brain, Peptide Fragments, Prognosis, Retrospective Studies, young adult
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