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Technical Refinement of a Bilateral Renal Ischemia-Reperfusion Mouse Model for Acute Kidney Injury Research
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Quantification of Renal Function and Cardiovascular Mortality in Patients Admitted to the Emergency Department with

Philipp Bahrmann, Thomas Bertsch, Evangelos Giannitsis

    Clinical Laboratory
    |September 8, 2017
    PubMed

    Insights

    Cystatin C levels effectively predict cardiovascular mortality in patients with suspected acute coronary syndromes (ACS). This renal function marker offers earlier detection of risk compared to serum creatinine, aiding in patient management.

    Area of Science:

    • Nephrology
    • Cardiology
    • Biomarkers

    Background:

    • Serum cystatin C increases early in chronic kidney disease (CKD), even before serum creatinine levels rise.
    • Patients with CKD have a higher risk of cardiovascular disease (CVD) and related premature death.
    • Serum creatinine levels can decrease with age, potentially masking underlying kidney issues.

    Purpose of the Study:

    • To evaluate cystatin C, serum creatinine, and estimated glomerular filtration rate (eGFR) as predictors of cardiovascular mortality.
    • To assess these markers in patients presenting to the emergency department (ED) with suspected acute coronary syndromes (ACS).

    Main Methods:

    • A prospective study involving 1,282 patients with suspected ACS.
    • Baseline measurements of cystatin C, serum creatinine, and eGFR were taken in the ED.
    • Clinical assessment and cardiac troponin T measurements were used for ACS diagnosis; cardiovascular deaths were tracked over 365 days.

    Main Results:

    • Univariate analysis showed significant associations for cystatin C (HR 12.02), serum creatinine (HR 4.53), and eGFR (HR 0.97) with cardiovascular mortality.
    • In a multivariate model including all three markers, cystatin C (HR 59.21) and serum creatinine (HR 0.08) remained significant predictors.
    • The risk association was significant for natural logarithms of cystatin C and serum creatinine.

    Conclusions:

    • Quantifying renal function using cystatin C is valuable for predicting cardiovascular mortality in patients with suspected ACS.
    • Cystatin C serves as an important biomarker for cardiovascular risk assessment in the ED setting.
    Abstract

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