Abstract 4060: Cystatin C and Cardiovascular Events in the Elderly: the Health, Aging, and Body Composition (Health ABC) Study
Objective: Chronic kidney disease has been associated with cardiovascular disease and mortality risk in elderly persons. As cystatin C has a more linear association with glomerular filtration rate (GFR) than creatinine, we evaluated the association of cystatin C with adverse cardiovascular events in ambulatory elderly persons.
Methods: The Health, Aging and Body Composition study (Health ABC) is a cohort of well-functioning, elderly participants aged 70–79 years at entry that was designed to evaluate longitudinal changes in weight, body composition and function. We measured serum cystatin C from baseline plasma samples of 3,044 participants and followed them over 6 years for the combined cardiovascular endpoint of cardiovascular death, stroke and myocardial infarction.
Results: The mean cystatin C was 1.05±0.34 mg/L. When modeled as a linear variable (per SD), cystatin C was associated significantly with cardiovascular death (HR 1.15; 95% CI: 1.04–1.27) after adjustment for comorbid conditions and inflammatory factors but not with myocardial infarction (HR 1.09; 95% CI: 0.93–1.27) or stroke (HR 1.06; 95% CI: 0.89–1.25). The associations of cystatin C with each cardiovascular outcome were attenuated by 20–40% after adjustment for inflammatory biomarkers.
Conclusions: Cystatin C was an independent predictor of cardiovascular death in this elderly cohort, but not of myocardial infarction or stroke. Inflammation appeared to have a moderately important effect as a mediator of this association.