%0 Journal Article
%T Preinterventional Cystatin C: A Highly Prognostic Marker for All-Cause Mortality after Coronarography
%A Florian L邦ders
%A Nasser Malyar
%A Matthias Meyborg
%A Holger Reinecke
%J Advances in Nephrology
%D 2014
%R 10.1155/2014/510209
%X Purpose. Glomerular filtration rate <60ˋmL/min/1.73ˋm2 is associated with increased all-cause mortality. Multiple studies have shown that serum cystatin C is more accurate than serum creatinine for detection of mild to moderate chronic kidney dysfunction. We examined the predictive value of the preinterventional cystatin C for all-cause mortality after contrast media exposition. Methods. The prognostic value of preinterventional cystatin C for all-cause mortality was retrospectively analysed in the prospective single-centre ※Dialysis-versus-Diuresis§ Trial (January 2001每July 2004). Associations during up to 1316 days of followup for all-cause mortality were assessed. The study population consisted of 373 patients (aged 35每89, mean 67 years, 16.4% female). Results. During followup, 65 deaths occurred. Multivariate cox regression confirmed the preinterventional CyC level to be an independent predictor of all-cause mortality (odds ratio 2.061, 95% confidence interval 1.054每4.031, ). Hazard rate ratio for all-cause mortality was increased in the third cystatin C quartile (>1.4ˋmg/L) compared with the lowest quartile (<1.1ˋmg/L), 4.12, 95% confidence interval 1.747每9.694 (), in the fourth cystatin C quartile (>1.6ˋmg/L) compared with the lowest quartile, 5.38, 95% confidence interval 2.329每12.427 (). Conclusions. Cystatin C is significantly associated with all-cause mortality after coronarography, regardless of the age, gender, and glomerular filtration rate. 1. Introduction Chronic kidney disease (CKD) is an important public health problem worldwide with a prevalence of 13% in the Western world [1, 2]. Chronic decreased glomerular filtration rate (GFR) less than 60ˋmL/min per 1.73ˋm2 is associated with an increased risk of developing cardiovascular disease (CVD) [2每6] and strongly associated with increased all-cause mortality [4]. Even mild to moderate renal impairment is associated with an increased risk of mortality [3, 4]. Cystatin C (CyC) and serum creatinine (SCr) are used as marker of renal function. A series of studies in the recent years have shown that serum CyC is superior to SCr for detection of mild to moderate renal impairment [7每9]. Comparably, CyC was also found to have a higher predictive value than SCr and GFR, based on Modification of Diet in Renal Disease equation for death so far only in selected cohorts such as elderly persons (>65 years) [10每13]. However, the role of preinterventional CyC in predicting all-cause mortality after contrast media (CM) exposition is not revealed. Our aim was to examine if the preinterventional cystatin C
%U http://www.hindawi.com/journals/an/2014/510209/