Impact of contrast-induced nephropathy and cardiovascular events by serum cystatin C in renal insufficiency patients undergoing cardiac catheterization.
We assessed the usefulness of serum cystatin C for predicting contrast-induced nephropathy (CIN) in patients (n = 100) undergoing coronary catheterization. After a 12-month follow-up, the incidence of CIN was 8.3% (n = 5) in patients with mild renal insufficiency (estimated glomerular filtration rate [eGFR] 60-89 mL/min per 1.73 m²), 34.4% (n = 10) in those with moderate renal insufficiency (eGFR 30-59 mL/min per 1.73 m²), and 100% (n = 3) in those with severe renal insufficiency (eGFR 15-29 mL/min per 1.73 m²). The sensitivity was 81.8% and specificity was 90.9% at the cutoff level of serum cystatin C >1.18 mg/L. Serum cystatin C levels were significantly (P < .001) higher in the patients with moderate renal insufficiency in the CIN group than those in the non-CIN group. Multivariate logistic regression analysis demonstrated that baseline serum cystatin C independently predicted short-term mortality (odds ratio [OR], 0.311; 95% confidence interval [CI] 0.058-0.538; P = .026). Baseline serum cystatin C significantly predicted the occurrence of CIN in the patients with moderate renal insufficiency.
Division of Cardiology, Department of Internal Medicine, St Marianna University School of Medicine, Miyamae-ku, Kawasaki city, Kanagawa, Japan. ishibashi15@yahoo.co.jp
Yuki
Y
Ishibashi
Masahiro
M
Yamauchi
Haruki
H
Musha
Taishi
T
Mikami
Kensuke
K
Kawasaki
Fumihiko
F
Miyake
D000368:Aged; D015415:Biomarkers / Q000097:blood; D006328:Cardiac Catheterization; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging; D003404:Creatinine / Q000097:blood; D055316:Cystatin C / Q000097:blood*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007674:Kidney Diseases / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D051437:Renal Insufficiency / Q000150:complications / Q000503:physiopathology*; D012680:Sensitivity and Specificity
D015415:Biomarkers; D003287:Contrast Media; D055316:Cystatin C; D003404:Creatinine