Abstract 8982: The Effect of Including Cystatin C or Creatinine in Cardiovascular Risk Model for Asymptomatic Individuals. The Multi-Ethnic Study of Atherosclerosis
Background: We studied the incremental value of adding either serum cystatin C or creatinine to the Framingham risk score variables (FRSV) for the prediction of incident cardiovascular disease (CVD) in a population without baseline CVD.
Methods: This study utilized data from the Multi-Ethnic Study of Atherosclerosis, a cohort of adults aged 45 – 84 years without baseline CVD. CVD was defined according to the criteria used in the Framingham Heart Study. The transformed continuous variables and non-transformed categorical variables were used to yield optimal prediction of 6-year CVD in models with FRSV, FRSV + cystatin C, and FRSV + creatinine, and they were fitted by using Cox proportional hazards models. Risk prediction in the three models was compared using c-statistic and reclassification table (RCT)-based measure: net reclassification improvement (NRI). NRI was calculated as a sum of differences in proportions of individuals moving up minus the proportion moving down for people who developed events and the proportion of individuals moving down minus the proportion moving up for people who did not develop events.
Results: After 6 years of follow-up, 447 (7.2%) CVD occurred in 6653 participants. C-statistic increased modestly from 0.722 to 0.733 in men and from 0.758 to 0.770 in women by adding cystatin C in contrast to no change (0.724 in men, 0.758 in women) by adding creatinine. RCTs are shown below. NRI of adding cystain C and creatinine to FRSV was 0.162 (p=0.48) and −0.009 (p=0.49), respectively.
Conclusions: The addition of cystatin C or creatinine to FRSV did not improve substantially overall prediction of incident CVD in adults without baseline CVD.
- © 2010 by American Heart Association, Inc.