Skip Navigation


European Heart Journal Advance Access originally published online on February 8, 2007
European Heart Journal 2007 28(15):1841-1847; doi:10.1093/eurheartj/ehl507
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
28/15/1841    most recent
ehl507v1
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (18)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Lassus, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Lassus, J.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Prognostic value of cystatin C in acute heart failure in relation to other markers of renal function and NT-proBNP

Johan Lassus1,*, Veli-Pekka Harjola2, Reijo Sund3, Krista Siirilä-Waris1, John Melin4, Keijo Peuhkurinen5, Kari Pulkki6, Markku S. Nieminen for the FINN-AKVA Study group1

1 Division of Cardiology, Department of Medicine, Helsinki University Central Hospital, Haartmaninkatu 4, POB 340, 00029 HUS, Helsinki, Finland
2 Division of Emergency Care, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland
3 National Research and Development Centre for Welfare and Health (STAKES), Helsinki, Finland
4 Department of Medicine, Central Finland Central Hospital, Jyväskylä, Finland
5 Department of Cardiology, Kuopio University Hospital, Kuopio, Finland
6 Department of Clinical Chemistry, Helsinki University, Helsinki, Finland

Received 31 August 2006; revised 13 December 2006; accepted 12 January 2007; online publish-ahead-of-print 8 February 2007.

* Corresponding author. Tel: +358 50 322 4094; fax: +358 9 47174015. E-mail address: johan.lassus{at}fimnet.fi

Aims: Cystatin C, a novel marker of renal function, has been implicated as a prognostic marker in cardiovascular disease. We investigated the prognostic value of cystatin C in acute heart failure (AHF) in comparison to other markers of renal function and NT-proBNP.

Methods and results: Patients with cystatin C measurements (n = 480) from a prospective multicentre study on AHF were included. All-cause mortality at 12 months was 25.4%. Cystatin C, creatinine, age, gender, and systolic blood pressure on admission were identified as independent prognostic risk factors. Cystatin C above median (1.30 mg/L) was associated with the highest adjusted hazard ratio, 3.2 (95% CI 2.0–5.3), P < 0.0001. Mortality increased significantly with each tertile of cystatin C. Combining tertiles of NT-proBNP and cystatin C improved risk stratification further. Moreover, in patients with normal plasma creatinine, elevated cystatin C was associated with significantly higher mortality at 12 months: 40.4% vs. 12.6% in patients with both markers within normal range, P < 0.0001.

Conclusion: Cystatin C is a strong and independent predictor of outcome at 12 months in AHF. Furthermore, cystatin C identifies patients with poor prognosis despite normal plasma creatinine. Cystatin C seems to be a promising risk marker in patients hospitalized for AHF.

Key Words: Cystatin C • Acute heart failure • Prognosis • Renal function • Biomarkers


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Clin. Chem.Home page
N. Taglieri, W. Koenig, and J. C. Kaski
Cystatin C and Cardiovascular Risk
Clin. Chem., November 1, 2009; 55(11): 1932 - 1943.
[Abstract] [Full Text] [PDF]

Home page
 Nephrol Dial TransplantHome page
M. Bell, F. Granath, J. Martensson, E. Lofberg, A. Ekbom, C.-R. Martling, and of KING (Karolinska Intensive care Nephrology Grou
Cystatin C is correlated with mortality in patients with and without acute kidney injury
Nephrol. Dial. Transplant., October 1, 2009; 24(10): 3096 - 3102.
[Abstract] [Full Text] [PDF]

Home page
 Eur J Heart FailHome page
U. Alehagen, U. Dahlstrom, and T. L. Lindahl
Cystatin C and NT-proBNP, a powerful combination of biomarkers for predicting cardiovascular mortality in elderly patients with heart failure: results from a 10-year study in primary care
Eur J Heart Fail, April 1, 2009; 11(4): 354 - 360.
[Abstract] [Full Text] [PDF]

Home page
 Circ Heart FailHome page
P. C. Patel, C. R. Ayers, S. A. Murphy, R. Peshock, A. Khera, J. A. de Lemos, J. A. Balko, S. Gupta, P. P.A. Mammen, M. H. Drazner, et al.
Association of Cystatin C With Left Ventricular Structure and Function: The Dallas Heart Study
Circ Heart Fail, March 1, 2009; 2(2): 98 - 104.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
M. Gheorghiade and P. S. Pang
Acute heart failure syndromes.
J. Am. Coll. Cardiol., February 17, 2009; 53(7): 557 - 573.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
T. Keller, C. M. Messow, E. Lubos, V. Nicaud, P. S. Wild, H. J. Rupprecht, C. Bickel, S. Tzikas, D. Peetz, K. J. Lackner, et al.
Cystatin C and cardiovascular mortality in patients with coronary artery disease and normal or mildly reduced kidney function: results from the AtheroGene study
Eur. Heart J., February 1, 2009; 30(3): 314 - 320.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
W.H. W. Tang and G. S. Francis
The Year in Heart Failure
J. Am. Coll. Cardiol., November 11, 2008; 52(20): 1671 - 1678.
[Full Text] [PDF]

Home page
 Vasc MedHome page
E. T Fung, A. M Wilson, F. Zhang, N. Harris, K. A Edwards, J. W Olin, and J. P Cooke
A biomarker panel for peripheral arterial disease
Vascular Medicine, August 1, 2008; 13(3): 217 - 224.
[Abstract] [PDF]

Home page
 Eur J Heart FailHome page
T. Ilva, J. Lassus, K. Siirila-Waris, J. Melin, K. Peuhkurinen, K. Pulkki, M. S. Nieminen, H. Mustonen, P. Porela, and V.-P. Harjola
Clinical significance of cardiac troponins I and T in acute heart failure
Eur J Heart Fail, August 1, 2008; 10(8): 772 - 779.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
W.H. W. Tang and G. S. Francis
The Year in Heart Failure
J. Am. Coll. Cardiol., December 11, 2007; 50(24): 2344 - 2351.
[Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.