Abstract 17860: Association Between Cystatin C and Red Cell Distribution Width with Cardiovascular Mortality Among a Nationally Representative Population and Normal Renal Function

Abstract

Background: Serum cystatin C, a marker of renal function and Red cell distribution width (RDW), a measure of anisocytosis, have recently generated interest as novel biomarkers predicting cardiovascular (CVD) and coronary heart disease (CHD) events independent of traditional risk factors. We sought to assess the prognostic value of these biomarkers for cardiovascular outcomes when used in combination compared to elevation of either of them alone.

Methods: The study cohort included 5395 adult participants (age >20years) free of CVD and normal creatinine-based estimated glomerular filtration rates from the National Health and Nutrition Examination Surveys III. To assess the risk associated with absolute increase in RDW (>13.3%) alone or absolute increase in cystatin C(>1.16mg/L) alone or presence of both, participants were divided into 4 groups: Group 1 - low RDW (≤13.3%) and low cystatin C (≤1.16 mg/L), reference category; Group 2 [[Unable to Display Character: –]] presence if high cystatin C levels and low RDW; Group 3 [[Unable to Display Character: –]] presence if high RDW and low cystatin C levels and Group 4 [[Unable to Display Character: –]] presence of high RDW and high cystatin C levels. Multivariate adjusted Cox-proportional hazard analysis was carried out with adjustment for traditional and non-traditional risk factors.

Results: Table 1.

Conclusion: Both RDW and cystatin C predict CVD and CHD mortality independently of each other and a combination of higher RDW and Cystatin C provides additive predictive value in this representative cohort of the US adults free of CVD and normal renal function.