Open AccessPotentials of Cystatin C and Uric Acid for Predicting Prognosis of Heart Failure
Author(s) -
Kim Hyungseop,
Yoon HyuckJun,
Park HyoungSeob,
Cho YunKyeong,
Nam ChangWook,
Hur SeungHo,
Kim YoonNyun,
Kim KwonBae
Publication year - 2012
Publication title -
congestive heart failure
Language(s) - English
Resource type - Journals
eISSN - 1751-7133
pISSN - 1527-5299
DOI - 10.1111/chf.12012
Subject(s) - medicine , heart failure , cystatin c , renal function , hazard ratio , creatinine , uric acid , blood urea nitrogen , cardiology , proportional hazards model , prospective cohort study , clinical endpoint , clinical trial , confidence interval
Few studies have explored the clinical potentials of combined Cystatin C (Cys) and uric acid (UA) in heart failure (HF). The authors evaluated Cys and UA as predictors of clinical outcomes compared with conventional renal biomarkers. This prospective cohort study included 587 HF patients presenting with dyspnea. At admission, Cys, UA, and other renal measures including serum urea nitrogen (BUN), creatinine (Cr), and glomerular filtration rate (GFR) were obtained. The primary endpoint was the composite of cardiac death and rehospitalization for worsening HF. During a 25‐month median follow‐up period, 68 patients experienced clinical outcomes: 9 cardiac deaths and 59 HFs. They showed higher BUN and Cr values and lower GFR. Within these parameters, Cys and UA had the most favorable area under the curves, and patients with Cys ≥0.8 mg/L and UA ≥6.6 mg/dL showed more frequent events. The net reclassification improvement analysis showed the combination of Cys and UA had a greater incremental effect for cardiac prognosis. On multivariate Cox hazard analysis, Cys and UA were independent predictive markers for clinical outcomes. In HF patients presenting with dyspnea, Cys and UA appear to be more useful predictors of clinical events than other renal measures.