title: A head-to-head comparison of homocysteine and cystatin C as pre-procedure predictors for contrast-induced nephropathy in patients undergoing coronary computed tomography angiography.
abstract: BACKGROUND
  Homocysteine is a potential predictor for contrast-induced nephropathy (CIN). We aimed to compare homocysteine with cystatin C as pre-procedure predictors for CIN in patients undergoing coronary computed tomography angiography (CCTA).
  
  
  METHODS
  A total of 580 consecutive patients were enrolled. Concentrations of plasma homocysteine and serum cystatin C were measured before CCTA. CIN is defined as an elevation of creatinine by ≥ 25% or ≥ 0.5mg/dl from baseline within 48h. Receiver operating characteristic curves, Pearson correlation coefficients and logistic regression analysis were used to evaluate the efficiency of potential predictors.
  
  
  RESULTS
  Fifty-seven (9.83%) patients developed CIN. Concentrations of homocysteine (19.35 ± 4.32 μmol/l vs. 13.42 ± 3.96 μmol/l, p<0.001) and cystatin C (1.20 ± 0.21 mg/dl vs. 0.99 ± 0.15 mg/dl, p<0.001) increased significantly in CIN subjects. CIN was predicted by homocysteine (AUC 0.829, p<0.001) and cystatin C (AUC 0.774, p<0.001), while creatinine was not predictive. Both homocysteine and cystatin C had positive correlation with ΔCreatinine48h-0 (p<0.001) and negative correlation with ΔeGFR48h-0 (p<0.001). Regression analysis confirmed that increased baseline homocysteine [OR: 1.262 (1.123, 2.554), p<0.001] and cystatin C [OR: 1.565 (1.380, 1.775), p<0.001] were independent predictors for CIN.
  
  
  CONCLUSIONS
  Homocysteine, with similar predictive value compared to cystatin C, was an independent biomarker for predicting CIN before CCTA examination.
authors: Department of Cardiology, The Third Affiliated Hospital, Sun Yat-sen University, Tian-he Road, Guangzhou 510630, China.
authors: Suhua
authors: S
authors: Li
authors: Advanced Medical Center, The Third Affiliated Hospital, Sun Yat-sen University, Tian-he Road, Guangzhou 510630, China.
authors: Xixiang
authors: X
authors: Tang
authors: Department of Cardiology, The Third Affiliated Hospital, Sun Yat-sen University, Tian-he Road, Guangzhou 510630, China.
authors: Long
authors: L
authors: Peng
authors: Department of Cardiology, The Third Affiliated Hospital, Sun Yat-sen University, Tian-he Road, Guangzhou 510630, China.
authors: Yanting
authors: Y
authors: Luo
authors: Department of Cardiology, The Third Affiliated Hospital, Sun Yat-sen University, Tian-he Road, Guangzhou 510630, China.
authors: Yunyue
authors: Y
authors: Zhao
authors: Department of Cardiology, The Third Affiliated Hospital, Sun Yat-sen University, Tian-he Road, Guangzhou 510630, China.
authors: Lin
authors: L
authors: Chen
authors: Department of Cardiology, The Third Affiliated Hospital, Sun Yat-sen University, Tian-he Road, Guangzhou 510630, China.
authors: Ruimin
authors: R
authors: Dong
authors: Department of Cardiology, The Third Affiliated Hospital, Sun Yat-sen University, Tian-he Road, Guangzhou 510630, China.
authors: Jieming
authors: J
authors: Zhu
authors: Advanced Medical Center, The Third Affiliated Hospital, Sun Yat-sen University, Tian-he Road, Guangzhou 510630, China.
authors: Yanming
authors: Y
authors: Chen
authors: Advanced Medical Center, The Third Affiliated Hospital, Sun Yat-sen University, Tian-he Road, Guangzhou 510630, China. Electronic address: medicine2lsh@163.com.
authors: Jinlai
authors: J
authors: Liu
mesh_terms: D015415:Biomarkers / Q000097:blood; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography; D055316:Cystatin C / Q000097:blood*; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D007674:Kidney Diseases / Q000097:blood* / Q000139:chemically induced; D012044:Regression Analysis; D014057:Tomography, X-Ray Computed
chemical_list: D015415:Biomarkers; D003287:Contrast Media; D055316:Cystatin C; D006710:Homocysteine
keywords: Computed tomography angiography; Contrast-induced nephropathy; Creatinine; Cystatin C; Homocysteine