Abstract 10061: Cystatin C-based Estimated Glomerular Filtration Rate Predict Cardiac Event in Chronic Heart Failure Patients More Precisely Than Creatinine-based Estimated Glomerular Filtration Rate.
Background It has been reported that renal function has strong association with clinical outcome in patients with chronic heart failure. Glomerular filtration rate (GFR) is the most accurate index for assessing renal function. Serum creatinine-based estimated glomerular filtration rate (sCr-eGFR) is associated with mortality and morbidity in patients with chronic heart failure (CHF). On the other hand, cystatin C, a novel endogenous marker of glomerular filtration, reflects renal function more directly than creatinine. Although serum creatinine is influenced by several factors such as age, gender and muscle mass, serum level of cystatin C is less affected. Therefore we compared prognostic value of cystatin C-based eGFR (cys-eGFR) to that of sCr-eGFR in CHF patients.
Methods and Results We calculated both sCr-eGFR and cys-eGFR using the following equation in 152 consecutive CHF patients at admission: sCr-eGFR (the new Japanese equation) =194 × Cr−1.094 ×Age−0.287 × 0.739 (if female): Cys-eGFR = 76.7 × [cystatin C]−1.18. Patients were prospectively followed during a median follow up period of 480 days, with the end points of cardiac death and cardiac event. A multivariate analysis with Cox proportional hazard model showed that cys-eGFR was one of the independent predictor of cardiac events. The area under the receiver operating characteristic curve was larger for cys-eGFR than sCr-eGFR (0.748 versus 0.661; P = 0.0149), suggesting that cys-eGFR had greater prediction capacity for cardiac events than sCr-eGFR. In addition, Kaplan-Meier analysis demonstrated that only cys-eGFR can strictly classify the prognosis of CHF patients not only with reduced eGFR (eGFR < 60 ml/min/1.73m2) but also with preserved eGFR (eGFR ≥ 60 ml/min/1.73m2).
Conclusions In CHF patients, cys-eGFR at admission could identify high risk patients more effectively than sCr-eGFR, and provides promising information for clinical outcome.
- © 2010 by American Heart Association, Inc.