- 作者：Juan Ignacio P¨¦rez-Calvo ; Francisco Jos¨¦ Ruiz-Ruiz ; Francisco Javier Carrasco-S¨¢nchez ; Jos¨¦ Luis Morales-Rull ; Sergio Manzano-Fern¨¢ndez ; Luis Galisteo-Almeda ; Domingo Pascual-Figal
- 关键词：Acute heart failure ; Biomarkers ; Cystatin C ; NTpro©\BNP
- 刊名：European Journal of Internal Medicine
- 出版年：2012
- 出版时间：October, 2012
- 年：2012
- 卷：23
- 期：7
- 页码：599-603
- 全文大小：333 K
Background
Cystatin C (CysC) is a good prognostic marker in heart failure. However, there is not much information of CysC combined with other biomarkers in acute heart failure (AHF).Aim
To assess prognostic value of CysC and N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients hospitalized for AHF with no apparent deterioration of renal function.
Design
Prospective, multicenter, observational study.
Methods
CysC and NTpro-BNP were measured in patients consecutively admitted with a diagnosis of AHF. Patients with, NTpro-BNP concentration above 900 pg/mL and serum creatinine below 1.3 mg/dL, were included for statistical analysis. End-point of the study was all-cause mortality during a 12-month follow-up.
Results
526 patients with AHF and NTpro-BNP concentration above 900 pg/mL were included in the study. From this group, 367 patients (69.8 % ) had serum creatinine below 1.3 mg/dL. Receiver operating characteristic (ROC) curves were used to determine the best cut-off value for CysC. Patients with a concentration of CsyC above 1.25 mg/dL had a 37.8 % mortality rate, vs. 13.6 % for those below cut-off (p < 0.001). After Cox proportional hazard model, age, CysC, low total cholesterol and HF with preserved ejection fraction remained significantly associated with all-cause mortality during one-year follow-up.
Conclusions
In AHF and normal or slightly impaired renal function, performance of CysC may be superior to NT-proBNP. Hence, CysC may be the preferred biomarker in the assessment of patients with AHF and slightly impaired renal function.