TY - JOUR
T1 - Elevated serum cystatin C level is an independent predictor of contrast-induced nephropathy and adverse outcomes in patients with peripheral artery disease undergoing endovascular therapy
AU - Kim, Gwang Sil
AU - Ko, Young Guk
AU - Shin, Dong Ho
AU - Kim, Jung Sun
AU - Kim, Byeong Keuk
AU - Choi, Donghoon
AU - Hong, Myeong Ki
AU - Jang, Yangsoo
N1 - Publisher Copyright:
Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc.
Copyright:
Copyright 2015 Elsevier B.V., All rights reserved.
PY - 2015/5/1
Y1 - 2015/5/1
N2 - Objective: The aim of this study was to investigate the association of serum cystatin C levels with contrast-induced nephropathy (CIN) and adverse clinical events in patients with peripheral artery disease (PAD). Methods: A total of 240 PAD patients who received endovascular therapy were included in this retrospective analysis. Serial serum levels of creatinine and cystatin C before and within 48 hours of endovascular therapy were evaluated for the incidence of CIN. The relationship between serum cystatin C levels and the incidence of major adverse events, defined as a composite of all-cause death, myocardial infarction, stroke, amputation, and target vessel revascularization, was investigated. Results The incidence of CIN increased from 1.7% to 27.9%, depending on the quartile of baseline cystatin C level. Baseline serum cystatin C level (area under the curve of the receiver operating characteristic curve, 0.757; 95% confidence interval [CI], 0.696-0.735) predicted the incidence of CIN better than baseline serum creatinine level (area under the curve, 0.629; 95% CI, 0.563-0.691; P <.001). An elevated baseline cystatin C level was an independent predictor of CIN (hazard ratio, 14.37; 95% CI, 4.11-50.19; P <.001) and major adverse events in patients with PAD (hazard ratio, 2.57; 95% CI, 1.28-5.17; P =.008). Conclusions We found elevated baseline cystatin C level to be an independent risk factor for CIN and a predictor of all-cause mortality and major adverse events in patients with PAD undergoing endovascular therapy.
AB - Objective: The aim of this study was to investigate the association of serum cystatin C levels with contrast-induced nephropathy (CIN) and adverse clinical events in patients with peripheral artery disease (PAD). Methods: A total of 240 PAD patients who received endovascular therapy were included in this retrospective analysis. Serial serum levels of creatinine and cystatin C before and within 48 hours of endovascular therapy were evaluated for the incidence of CIN. The relationship between serum cystatin C levels and the incidence of major adverse events, defined as a composite of all-cause death, myocardial infarction, stroke, amputation, and target vessel revascularization, was investigated. Results The incidence of CIN increased from 1.7% to 27.9%, depending on the quartile of baseline cystatin C level. Baseline serum cystatin C level (area under the curve of the receiver operating characteristic curve, 0.757; 95% confidence interval [CI], 0.696-0.735) predicted the incidence of CIN better than baseline serum creatinine level (area under the curve, 0.629; 95% CI, 0.563-0.691; P <.001). An elevated baseline cystatin C level was an independent predictor of CIN (hazard ratio, 14.37; 95% CI, 4.11-50.19; P <.001) and major adverse events in patients with PAD (hazard ratio, 2.57; 95% CI, 1.28-5.17; P =.008). Conclusions We found elevated baseline cystatin C level to be an independent risk factor for CIN and a predictor of all-cause mortality and major adverse events in patients with PAD undergoing endovascular therapy.
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U2 - 10.1016/j.jvs.2014.11.079
DO - 10.1016/j.jvs.2014.11.079
M3 - Article
C2 - 25595408
AN - SCOPUS:84929029327
VL - 61
SP - 1223
EP - 1230
JO - Journal of Vascular Surgery
JF - Journal of Vascular Surgery
SN - 0741-5214
IS - 5
ER -