Differential prognostic utility of NTproBNP and Cystatin C in patients with acute exacerbation of chronic pulmonary disease

Pérez-Calvo, Juan Ignacio; Sánchez‐Marteles, Marta; Fj, Ruiz-Ruiz; Morales-Rull, José-Luis; Nieto-Rodríguez, José-Antonio

doi:10.1258/shorts.2010.010059

Cited by 6 publications

(6 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is carried out by inflammatory mediators like serine proteases, metalloproteinases etc. 10 Amongst various complications of COPD, cardiovascular disease is being increasingly recognized as an important cause of morbidity and a predictor of in-hospital mortality in these patients as acute respiratory failure in patients may lead to right or left ventricular failure. It was found in one of the studies that 12-37% of patients of COPD died of cardiovascular diseases.…”

Section: Discussionmentioning

confidence: 99%

Cardiac troponin I as mortality predictor in acute exacerbation of chronic obstructive pulmonary disease

et al. 2017

View full text Add to dashboard Cite

Background: Comorbidities are important determinants of outcome and quality of life of patients with chronic obstructive pulmonary disease (COPD). The risk of cardiovascular events in COPD patients is three to five-fold high. COPD is often associated with right ventricular hypertrophy and pulmonary hypertension. Various studies have associated levels of cardiac troponin I (cTnI) with severity and duration of acute exacerbation of COPD (AECOPD). The objective of the present study was to assess the usefulness of serum cTnI as mortality predictor in AECOPD patients.Methods: An observational, prospective and non interventional study was conducted in 50 patients with AECOPD admitted in the pulmonary medicine emergency or ward of a tertiary care hospital of Northern India. AECOPD was diagnosed according to Global Initiative for chronic obstructive lung disease guidelines. cTnI levels were estimated within 24 hours of admission by method based on chemiluminiscence along with routine investigations. Levels ≥ 0.01ng/ml were taken as positive. The patients were followed up for 30days for outcome in terms of mortality and morbidity. Data was entered and analyzed by SPSS package and two sided p values<0.05 were considered statistically significant.Results: The serum cTnI was found to be positive in 34% of patients with AECOPD. The in- hospital mortality was significantly low in patients having cTnI <0.01ng/ml as compared to patients with cTnI ≥0.01ng/ml. The patients with cTnI levels ≥0.01ng/ml had significantly higher mean PaCO2 levels and higher requirement for invasive or noninvasive ventilation during hospital stay as compared to patients having cTnI <0.01ng/ml (p=0.04 and 0.016 respectively).Conclusions: Levels of cTnI≥0.01ng/ml may be considered as a biomarker to predict mortality in AECOPD patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Cardiac troponin I as mortality predictor in acute exacerbation of chronic obstructive pulmonary disease

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Takeyabu et al 25 reported that increased levels of CysC were present in the bronchoalveolar lavage fluid from subjects with subclinical emphysema. Pérez-Calvo et al 15 analyzed CysC levels at the time of admission in 107 subjects with exacerbation of chronic lung disease. During a 12-month follow-up, the mortality, new hospital admissions, and prescriptions of diuretics were recorded.…”

Section: Discussionmentioning

confidence: 99%

“…14 Another study examined the 1-y prognostic value of elevated CysC among subjects with exacerbation of chronic lung disease who were hospitalized and showed that CysC has no predictive value for mortality in subjects with chronic respiratory disease. 15 However, no articles have presented an evaluation of the prognostic value of CysC in subjects with COPD exacerbation. It is possible that CysC measurements can contribute to the early identification of patients at risk for the development of clinically important ventricular dysfunction.…”

mentioning

confidence: 99%

Cystatin C as a Predictor of In-Hospital Mortality After Exacerbation of COPD

Zhou

et al. 2016

Respir Care

View full text Add to dashboard Cite

BACKGROUND: COPD is associated with cardiovascular and renal dysfunction. Cystatin C (CysC) is a biomarker of renal function and an independent risk factor for all-cause and cardiovascular mortality among elderly persons. The aim of the study was to examine the prognostic role of CysC for in-hospital mortality in subjects with a COPD exacerbation. METHODS: Upon admission, serum CysC levels and arterial blood gas analysis from 477 subjects with a COPD exacerbation were measured. Clinical characteristics were also recorded. A receiver operating characteristic curve analysis was used to determine the level of CysC that discriminated survivors from nonsurvivors. Univariate and multiple logistic regression analyses were used to identify the risk factors for in-hospital mortality. To reduce the influence of confounders, subgroup analyses were performed according to the comorbidities, including states of heart failure, renal dysfunction, and pH, P aCO 2 , and P aO 2 levels. RESULTS: During the in-hospital period, 59 subjects died, and 418 subjects recovered. The decedent group showed lower pH (7.27 ؎ 0.17 vs 7.38 ؎ 0.06, P < .001), higher CysC (2.21 ؎ 1.05 mg/L vs 1.39 ؎ 0.54 mg/L, P < .001), higher P aCO 2 (77 ؎ 39 mm Hg vs 48 ؎ 14 mm Hg, P < .001), and lower P aO 2 (74 ؎ 32 mm Hg vs 84 ؎ 26 mm Hg, P < .001) levels. The area under the receiver operating characteristic curve for the CysC prediction of death was 0.77 (95% CI 0.70 -0.84). CysC values >1.59 mg/L were associated with significantly higher inhospital mortality (relative risk ‫؍‬ 5.49, 95% CI 3.24 -9.32, P < .001). Multiple logistic regression analysis showed that pH <7.20, CysC >1.59 mg/L, and heart failure were independent predictors of in-hospital mortality. The subgroup analysis showed that the comorbid states of renal dysfunction, congestive heart failure, and the levels of pH, P aCO 2 , and P aO 2 did not alter the conclusion that CysC was a mortality risk factor for subjects with a COPD exacerbation. CONCLUSION: CysC was a strong and independent risk factor for hospital mortality secondary to COPD exacerbation.

show abstract

“…In patients with chronic respiratory diseases N-terminal pro-B-type natriuretic peptide has predictive value in terms of mortality whereas Cystatin C alone does not 51 . When used together, Cystatin C adds complementary information to the data provided by N-terminal pro-B-type natriuretic peptide alone; contributing valuable information to the early identification of patients at risk of developing clinical ventricular dysfunction 51 .This combined biomarker analysis could be an alternative for identifying patients at increased risk, even though they only have slightly impaired cardiac or renal function but may be said to have cardio-renal syndrome 45 .…”

Section: Cardiovascularmentioning

confidence: 95%

“…Epidemiologic studies have shown that Cystatin C is an independent predictor in older adults, more sensitive than creatinine and glomerular filtration rate for detecting a high risk of with an increased risk of renal disease progression, death, or cardiovascular events, death and cardiovascular events in a population with chronic kidney disease 49 50 . It also provided significant prognostic information, in terms of morbidity and mortality, among hypertensive, coronary, acute and chronic heart failure patients 51 .…”

Section: Cardiovascularmentioning

confidence: 99%

Clinical Role, Diagnostic and Prognostic Value of Human Cystatin C Through the Body

Viniegra¹,

Shiguetomi²,

Glogauer³

2018

CMRJ

View full text Add to dashboard Cite

Cystatin C is a low-molecular-weight biomarker that meets the conditions necessary to be a marker of the glomerular filtration rate. This endogenous cysteine proteinase inhibitor belonging to the type 2 cystatin superfamily plays a key role in health and disease. Human cystatin C is encoded by the CST3 gene, ubiquitously expressed at moderate levels throughout the body, given it is produced in all nucleated cells in a constant amount. It is present in all human body fluids, and may be determined in the serum, plasma, capillary blood and urine. In this review, we present and discuss most of the available data from the literature for the use of cystatin C in clinical practice. In addition to a kidney function marker, studies suggest cystatin C could be used as a marker for cardiovascular risk assessment, in predicting and detecting preeclampsia, in patients with malignant neoformations, etc. Local cystatin C deficiency has also been demonstrated in atherosclerosis, aneurismal lesions, among others, suggesting a protective role of cystatin C. Far beyond its humble beginning, it promises uses from prognosis to treatments for everything from prostate cancer to periodontal disease. Cystatin C has begun its journey into a multitude of disciplines; we can only begin to imagine the many more purposes yet to find going forward.

show abstract

Differential prognostic utility of NTproBNP and Cystatin C in patients with acute exacerbation of chronic pulmonary disease

Cited by 6 publications

References 23 publications

Cardiac troponin I as mortality predictor in acute exacerbation of chronic obstructive pulmonary disease

Cardiac troponin I as mortality predictor in acute exacerbation of chronic obstructive pulmonary disease

Cystatin C as a Predictor of In-Hospital Mortality After Exacerbation of COPD

Clinical Role, Diagnostic and Prognostic Value of Human Cystatin C Through the Body

Contact Info

Product

Resources

About