Association Between Cystatin C and Cardiac Function and Long-Term Prognosis in Patients with Chronic Heart Failure
Xilin Wu, Ge Xu, Shiming Zhang
Department of Cardiology, First Affiliated Hospital of Guangxi University of Science and Technology, Liuzhou, Guangxi, China (mainland)
Med Sci Monit 2020; 26:e919422
Available online: 2020-01-21
The aim of this study was to investigate the association between cystatin C and cardiac function and long-term prognosis in patients with chronic heart failure (CHF).
MATERIAL AND METHODS: We selected 418 CHF patients admitted to our hospital as subjects. Patients were divided into 3 groups according to the cystatin C level (Quantile 1 group: 0.65-1.04 mg/L, Quantile 2 group: 1.05-1.35 mg/L, and Quantile 3 group: 1.36-7.84 mg/L), and patients were followed up for 5 years. We used odds ratio (OR) and 95% confidence interval (CI) to compare the results.
RESULTS: The cystatin C and NT-ProBNP level in the cardiac function grade (NYHA) class IV group were higher than those in the class III group (P<0.05). Pearson correlation analysis showed that there was a positive correlation between cystatin C and NT-ProBNP log₁₀ transform in CHF patients (r=0.411). During 5-year follow-up, 231 patients died and the 5-year all-cause mortality rate was 55.26% (231/418). There was a significant difference in 5-year all-cause mortality among the 3 groups (P for trend=0.010). After adjusting for potential confounders by multivariate regression analysis, the Quantile 2 group vs. Quantile 1 group were OR=0.83, 95% CI 0.51 to 1.35, P=0.448, and the Quantile 3 group vs. Quantile 1 group were OR=1.71, 95% CI. 1.04 to 2.82, P=0.034. Curve fitting showed that cystatin C was positively correlated with 5-year all-cause mortality in CHF patients.
CONCLUSIONS: Cystatin C was positively correlated with cardiac function and NT-ProBNP in CHF patients. Cystatin C could be used as a serological index to evaluate the long-term prognosis of CHF patients.
Keywords: cystatin C, Heart Failure, Mortality