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Updated: Jul 2, 2026

Anatomical Reconstructions of the Human Cardiac Venous System using Contrast-computed Tomography of Perfusion-fixed Specimens
06:02

Anatomical Reconstructions of the Human Cardiac Venous System using Contrast-computed Tomography of Perfusion-fixed Specimens

Published on: April 18, 2013

Valuable markers for contrast-induced nephropathy in patients undergoing cardiac catheterization

Koji Kato1, Naoki Sato, Takeshi Yamamoto

  • 1Intensive and Cardiac Care Unit, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan. katokoji@nms.ac.jp

Circulation Journal : Official Journal of the Japanese Circulation Society
|August 30, 2008
PubMed

Insights

Serum cystatin C effectively predicts contrast-induced nephropathy (CIN) before cardiac catheterization. Elevated cystatin C levels indicate a higher risk of developing CIN, aiding in early detection and management.

Area of Science:

  • Nephrology
  • Cardiology
  • Clinical Chemistry

Background:

  • Contrast-induced nephropathy (CIN) is a common complication following cardiac catheterization.
  • Early detection and prediction of CIN are crucial for patient management.

Purpose of the Study:

  • To evaluate the predictive utility of pre-catheterization cystatin C for CIN.
  • To establish a diagnostic cut-off level for cystatin C in predicting CIN.
  • To compare cystatin C with other biomarkers for CIN detection.

Main Methods:

  • Prospective study of 87 patients undergoing elective cardiac catheterization.
  • Measurement of cystatin C, creatinine, urinary L-FABP, alpha1, beta2 microglobulins, and N-acetyl-beta-D-glucosaminidase before and after catheterization.
  • Receiver-operating characteristic (ROC) analysis to assess diagnostic performance.

Main Results:

  • Cystatin C demonstrated a higher area-under-the-curve (0.933) than serum creatinine (0.832) in predicting CIN (p=0.012).
  • A cystatin C cut-off level of >1.2 mg/L showed 94.7% sensitivity and 84.8% specificity for CIN detection.
  • Pre-catheterization cystatin C levels were significantly higher in patients who developed CIN (1.36±0.28 mg/L) compared to those who did not (1.08±0.22 mg/L; p=0.007).
  • Urinary L-FABP indicated transient renotubular damage in patients with moderate renal disease.

Conclusions:

  • Pre-catheterization cystatin C is a valuable predictor of CIN.
  • Cystatin C offers superior diagnostic performance compared to serum creatinine for CIN prediction.
  • Urinary L-FABP serves as an indicator of transient renotubular injury.
Abstract

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