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Higher cystatin C level predicts long-term mortality in patients with peripheral arterial disease

Grazina Urbonaviciene1, Guo Ping Shi, Sigitas Urbonavicius

  • 1Vascular Research Unit, Department of Vascular Surgery, Viborg Hospital, Heibergs Allé 4, DK-8800 Viborg, Denmark. Grazina.urbonaviciene@sun.au.dk

Atherosclerosis
|March 11, 2011
PubMed

Insights

Elevated cystatin C levels independently predict mortality in peripheral arterial disease (PAD) patients. While cystatin C aids risk prediction, its clinical utility for cardiovascular events in PAD may be limited.

Area of Science:

  • Cardiovascular Research
  • Biomarker Discovery
  • Atherosclerosis Studies

Background:

  • Cystatin C and cathepsins are implicated in atherosclerotic disease progression.
  • Peripheral arterial disease (PAD) is associated with increased mortality risk.

Purpose of the Study:

  • To investigate the relationship between cystatin C, cathepsin L, and cathepsin S levels and lethal outcomes in patients with PAD.
  • To assess the prognostic value of cystatin C for cardiovascular mortality in PAD.

Main Methods:

  • Study included 378 patients with established PAD.
  • Cox regression analysis was used to evaluate associations between serum biomarkers and mortality.
  • C-statistic and net reclassification improvement (NRI) assessed cystatin C's predictive accuracy.

Main Results:

  • Higher cystatin C levels (above 1 mg/l) significantly increased adjusted risk for all-cause and cardiovascular mortality in PAD patients.
  • This association remained significant even in PAD patients without renal impairment.
  • Adding cystatin C to conventional risk factors improved cardiovascular mortality prediction accuracy but showed modest reclassification.

Conclusions:

  • Higher cystatin C levels are an independent predictor of 5-year all-cause and cardiovascular death in PAD.
  • The modest improvement in risk prediction and lack of significant reclassification suggest limited clinical utility of cystatin C for cardiovascular mortality prediction in PAD.
Abstract

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