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.

Abstract

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.

• Authors: Gwang-Sil Kim, Young-Guk Ko, Dong-Ho Shin, Jung-Sun Kim, Byeong-Keuk Kim, Donghoon Choi, Myeong-Ki Hong, Yangsoo Jang
• Journal: Journal of vascular surgery (J Vasc Surg) Vol. 61 Issue 5 Pg. 1223-30 (May 2015) ISSN: 1097-6809 [Electronic] United States
• PMID: 25595408 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Chemical References

• Biomarkers
• Contrast Media
• Cystatin C
• Creatinine

Topics

• Aged
• Angiography (adverse effects)
• Angioplasty (adverse effects)
• Arterial Occlusive Diseases (blood, diagnostic imaging, therapy)
• Biomarkers (blood)
• Contrast Media (adverse effects)
• Creatinine (blood)
• Cystatin C (blood)
• Female
• Humans
• Intermittent Claudication (blood, diagnostic imaging, therapy)
• Ischemia (blood, diagnostic imaging, therapy)
• Kidney Function Tests
• Leg (blood supply)
• Male
• Middle Aged
• Proportional Hazards Models
• Renal Insufficiency (blood, chemically induced)
• Retrospective Studies
• Risk Factors