Table of Contents
Advances in Nephrology
Volume 2014, Article ID 510209, 6 pages
http://dx.doi.org/10.1155/2014/510209
Research Article

Preinterventional Cystatin C: A Highly Prognostic Marker for All-Cause Mortality after Coronarography

Department of Cardiology and Angiology, University Hospital of Muenster, 48129 Muenster, Germany

Received 30 June 2014; Accepted 14 September 2014; Published 25 September 2014

Academic Editor: Carlos G. Musso

Copyright © 2014 Florian Lüders et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. Glomerular filtration rate <60 mL/min/1.73 m2 is associated with increased all-cause mortality. Multiple studies have shown that serum cystatin C is more accurate than serum creatinine for detection of mild to moderate chronic kidney dysfunction. We examined the predictive value of the preinterventional cystatin C for all-cause mortality after contrast media exposition. Methods. The prognostic value of preinterventional cystatin C for all-cause mortality was retrospectively analysed in the prospective single-centre “Dialysis-versus-Diuresis” Trial (January 2001–July 2004). Associations during up to 1316 days of followup for all-cause mortality were assessed. The study population consisted of 373 patients (aged 35–89, mean 67 years, 16.4% female). Results. During followup, 65 deaths occurred. Multivariate cox regression confirmed the preinterventional CyC level to be an independent predictor of all-cause mortality (odds ratio 2.061, 95% confidence interval 1.054–4.031, ). Hazard rate ratio for all-cause mortality was increased in the third cystatin C quartile (>1.4 mg/L) compared with the lowest quartile (<1.1 mg/L), 4.12, 95% confidence interval 1.747–9.694 (), in the fourth cystatin C quartile (>1.6 mg/L) compared with the lowest quartile, 5.38, 95% confidence interval 2.329–12.427 (). Conclusions. Cystatin C is significantly associated with all-cause mortality after coronarography, regardless of the age, gender, and glomerular filtration rate.