Cystatin C, a Novel Measure of Renal Function, Is an Independent Predictor of Cardiac Events in Patients With Heart Failure

Arimoto, Takanori; Takeishi, Yasuchika; Niizeki, Takeshi; Takabatake, Noriaki; Okuyama, Hiroomi; Fukui, Akio; Tachibana, Hidetada; Nakatani, Naoki; Hirono, Osamu; Tsunoda, Yuichi; Miyashita, Takehiko; Shishido, Tetsuro; Takahashi, Hiroki; Koyama, Yo; Kubota, Isao

doi:10.1016/j.cardfail.2005.06.001

Cited by 81 publications

(63 citation statements)

References 18 publications

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“…Exclusion criteria in the present study included: patients with clinical or electrocardiographic evidence suggestive of acute coronary syndrome within 3 months preceding admission, those with renal failure characterized by a serum creatinine concentration ≥1.5 mg/dl, and those with active hepatic or pulmonary disease. [15][16][17][18][19] Informed consent was obtained from all patients before participation in this study, and the study protocol was approved by the Human Investigations Committee of our institution.…”

Section: Study Populationmentioning

confidence: 99%

“…The diagnosis of CHF was based on a history of dyspnea and symptomatic exercise intolerance with signs of pulmonary congestion or peripheral edema or documentation of left ventricular enlargement or dysfunction by chest X-ray film, echocardiography, or radionuclide ventriculography. [15][16][17][18][19] The etiologies of CHF were dilated cardiomyopathy in 48 patients, ischemic heart disease in 34 patients, valvular heart disease in 20 patients, and hypertensive heart disease in 12 patients. A diagnosis of hypertension, diabetes, and hyperlipidemia were obtained from medical records or patient history of currently or previously received medical therapy.…”

Section: Study Populationmentioning

confidence: 99%

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Serum Resistin is Associated With High Risk in Patients With Congestive Heart Failure A Novel Link Between Metabolic Signals and Heart Failure

Takeishi

Niizeki

Arimoto

et al. 2007

Circ J

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Background Resistin is derived from fat tissue in rodents, and serum levels are elevated in animal models of obesity and insulin resistance. Recent studies have reported that resistin is correlated with markers of inflammation and oxidative stress and is predictive of coronary atherosclerosis in humans. However, clinical significance of serum resistin has not been examined in heart failure. Therefore, the purpose of this study was to examine whether: (1) resistin is correlated with the severity of heart failure; and (2) resistin can predict clinical outcomes of patients with heart failure. Methods and Results Serum levels of resistin in 126 patients hospitalized for heart failure and 18 control subjects were measured. The patients were followed up with end-points of cardiac death and re-hospitalization caused by worsening of heart failure. The serum resistin level was higher in patients with heart failure than in control subjects and increased with advancing New York Heart Association functional class. The normal upper limit of the resistin level was determined as the mean +2 standard deviation value of control subjects (14.1 ng/ml). In heart failure patients, the cardiac event rate was higher in patients with a high resistin level than in those with a normal level. Among age, body mass index, serum levels of resistin, brain natriuretic peptide, loop diuretics selected by the univariate Cox regression hazard analysis, age and resistin were significant predictors of future cardiac events by multivariate Cox analysis. Conclusion Serum resistin was related to the severity of heart failure and associated with a high risk for adverse cardiac events in patients with heart failure. (Circ J 2007; 71: 460 -464)

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Section: Study Populationmentioning

confidence: 99%

Section: Study Populationmentioning

confidence: 99%

Serum Resistin is Associated With High Risk in Patients With Congestive Heart Failure A Novel Link Between Metabolic Signals and Heart Failure

Takeishi

Niizeki

Arimoto

et al. 2007

Circ J

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“…60) In the study by Arimoto, et al, Cox multivariate proportional hazard analysis revealed that the cystatin C level was the independent predictor for cardiac events (hazard ratio, 2.93; 95% CI, 1.29 -6.64; P < 0.01), and that the cardiac event rate was markedly higher in patients with an elevated cystatin C level than in those with a normal level (44.2% versus 13.4%, P < 0.001). 61) Furthermore, in patients with normal creatinine levels (n = 91), the cardiac event rate was similarly higher in patients with elevated cystatin C than in those with normal levels (36.4% versus 10.0%, P = 0.003).…”

Section: Renal Functionmentioning

confidence: 86%

Biomarkers in Heart Failure

Takeishi

2014

Int. Heart J.

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SummaryAppropriate use of biomarkers is clinically important for identifying heart failure in its early stage, optimizing risk stratification, and managing patients. This article describes established and traditional biomarkers as well as novel biomarkers reflective of myocardial stress, myocardial damage, extracellular matrix, oxidative stress, inflammation, renal function, micro RNAs, and heart failure with preserved left ventricular ejection fraction. This review focuses on the recent advances in cardiac and non-cardiac biomarkers of heart failure and their appropriate use in clinical practice. (Int Heart J 2014; 55: 474-481) Key words: BNP, NT-proBNP, ST2, Troponin, H-FABP, Galectin-3, Cystatin C, Pentraxin 3 C ardiovascular diseases are the predominant cause of death in developed countries. Among the afflicted, patients with heart failure are increasing, and this complex syndrome is becoming a public health problem, especially with the aging of populations. To establish diagnostic, therapeutic, and prognostic strategies, the identification of reliable biomarkers for heart failure is necessary.1,2) Although a number of biomarkers have been developed, the ideal biomarkers should meet certain criteria: 1) non-invasive sample collection, 2) a high degree of sensitivity and specificity, 3) able to detect the disease at an early stage, 4) sensitivity high enough to reflect relevant changes in disease conditions, 5) a long halflife within the sample, 6) rapid measurement system responding to clinical needs, and 7) low cost. 3,4) In this article, the focus will be on the recent advances in cardiac and non-cardiac biomarkers of heart failure and their appropriate use in clinical practice. Myocardial Stress MarkersB-type natriuretic peptide: B-type natriuretic peptide (BNP) is a well-established biomarker, extensively used for the diagnosis and prognosis of patients with heart failure. BNP is a cardiac hormone, identified as the second compound of the natriuretic peptide family and secreted predominantly from the ventricle in response to mechanical overload. 5) In the failing heart, increased wall stress and neurohormonal activation facilitate BNP secretion chiefly from ventricular myocytes. BNP promotes diuresis, vasodilatation, and attenuation of renin and aldosterone secretion. Tsutamoto, et al initially measured plasma levels of BNP in 85 patients with chronic heart failure and a left ventricular ejection fraction (LVEF) of less than 0.45. 6)The plasma levels of BNP increased in proportion to the severity of heart failure. Plasma levels of BNP were 5-fold higher in non-survivors than in survivors. Among clinical and hemodynamic parameters, Cox proportional hazard analysis revealed that only plasma BNP (P < 0.0001) and pulmonary capillary wedge pressure (P = 0.003) were significant independent predictors of mortality in patients with heart failure. Plasma levels of BNP provided prognostic information independent of other variables previously associated with a poor prognosis. To date, a number of studies have r...

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“…Moreover, the serum level of cystatin-C is known to be unaffected by muscle mass or physical activity level and minimally affected by age or gender, whereas serum Cr is dependent on these factors. 9,10,17) Thus, the level of serum cystatin-C more adequately reflects the filtering function of glomeruli than other markers, including serum Cr. [8][9][10]17) Although the clinical role of cystatin-C associated with CVD has not been clearly delineated, some previous reports have suggested its potential as an important predictor of CVD.…”

Section: Discussionmentioning

confidence: 99%

“…9,10,17) Thus, the level of serum cystatin-C more adequately reflects the filtering function of glomeruli than other markers, including serum Cr. [8][9][10]17) Although the clinical role of cystatin-C associated with CVD has not been clearly delineated, some previous reports have suggested its potential as an important predictor of CVD. Shlipak, et al compared Cr and cystatin-C levels as predictors of cardiovascular events including cardiac death, myocardial infarction, and stroke in 4,637 non-CKD subjects 18) and found that a high concentration of cystatin-C was clearly associated with the incidence of all cardiovascular events, and that cystatin-C, but not serum Cr, had a strong predictive association with the risk of these events.…”

Section: Discussionmentioning

confidence: 99%

Impact of Cystatin-C Level on the Prevalence and Angiographic Characteristics of Vasospastic Angina in Korean Patients

et al. 2015

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SummaryCystatin-C, a marker of mild renal dysfunction, has been reported to be associated with cardiovascular diseases including vasospastic angina (VSA). We aimed to investigate the impact of cystatin-C level on the prevalence and angiographic characteristics of VSA in Korean patients.A total of 549 patients in the VA-KOREA (Vasospastic Angina in KOREA) registry who underwent ergonovine provocation tests were consecutively enrolled. Estimated glomerular filtration rate (eGFR) and levels of serum creatinine (Cr) and cystatin-C were assessed before angiography.The patients were classified into two groups: the VSA group (n = 149, 27.1%) and the non-VSA group (n = 400). Although eGFR and Cr levels were similar between the two groups, the VSA group had a significantly higher level of cystatin-C (P < 0.05). A high level of cystatin-C (second tertile, hazard ratio 1.432; 95% confidence interval [1.149-1.805]; P = 0.026, third tertile, 1.947 [1.132-2.719]; P = 0.003) and current smoking (2.710 [1.415-4.098]; P < 0.001) were independently associated with the prevalence of VSA. Furthermore, the highest level of cystatin-C (> 0.96 ng/mL) had a significant impact on the incidence of multivessel spasm (2.608 [1.061-4.596]; P = 0.037).A high level of cystatin-C was independently associated with the prevalence of VSA and with a high-risk type of VSA in Korean patients, suggesting that proactive investigation of VSA should be considered for patients with mild renal dysfunction indicated by elevated cystatin-C. (Int Heart J 2015; 56: 49-55)

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Cystatin C, a Novel Measure of Renal Function, Is an Independent Predictor of Cardiac Events in Patients With Heart Failure

Cited by 81 publications

References 18 publications

Serum Resistin is Associated With High Risk in Patients With Congestive Heart Failure A Novel Link Between Metabolic Signals and Heart Failure

Serum Resistin is Associated With High Risk in Patients With Congestive Heart Failure A Novel Link Between Metabolic Signals and Heart Failure

Biomarkers in Heart Failure

Impact of Cystatin-C Level on the Prevalence and Angiographic Characteristics of Vasospastic Angina in Korean Patients

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