title: The effect of including cystatin C or creatinine in a cardiovascular risk model for asymptomatic individuals: the multi-ethnic study of atherosclerosis.
abstract: The authors studied the incremental value of adding serum cystatin C or creatinine to the Framingham risk score variables (FRSVs) for the prediction of incident cardiovascular disease (CVD) among 6,653 adults without clinical CVD utilizing the Multi-Ethnic Study of Atherosclerosis (2000-2008). CVD events included coronary heart disease, heart failure, stroke, and peripheral arterial disease. Variables were transformed to yield optimal prediction of 6-year CVD events in sex-stratified models with FRSVs alone, FRSVs + cystatin C, and FRSVs + creatinine. Risk prediction in the 3 models was assessed by using the C statistic, and net reclassification improvement was calculated. The mean ages were 61.9 and 64.6 years for individuals with and without diabetes, respectively. After 6 years of follow-up, 447 (7.2%) CVD events occurred. In the total cohort, no significant change in the C statistic was noted with FRSVs + cystatin C and FRSVs + creatinine compared with FRSVs alone, and net reclassification improvement for CVD risk was extremely small and not significant with the addition of cystatin C or creatinine to FRSVs. Similar findings were noted after stratifying by baseline presence of diabetes. In conclusion, the addition of cystatin C or serum creatinine to FRSVs does not improve CVD risk prediction among adults without clinical CVD.
authors: Division of Cardiology, Loyola University Medical Center, Maywood, IL 60153, USA. itohiroki@gmail.com
authors: Hiroki
authors: H
authors: Ito
authors: Ivan V
authors: IV
authors: Pacold
authors: Ramon
authors: R
authors: Durazo-Arvizu
authors: Kiang
authors: K
authors: Liu
authors: Michael G
authors: MG
authors: Shilipak
authors: David C
authors: DC
authors: Goff
authors: Russell P
authors: RP
authors: Tracy
authors: Holly
authors: H
authors: Kramer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000097:blood*; D003404:Creatinine / Q000097:blood*; D055316:Cystatin C / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D018570:Risk Assessment / Q000379:methods
chemical_list: D055316:Cystatin C; D003404:Creatinine