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CYSTATIN C- AND CREATININE-BASED DEFINITIONS OF CONTRAST-INDUCED NEPHROPATHY AFTER CORONARY ANGIOGRAPHY OR PERCUTANEOUS CORONARY INTERVENTION
330 JACC April 5, 2016 Volume 67, Issue 13
ACC.i2 Interventional Cardiology CYSTATIN C- AND CREATININE-BASED DEFINITIONS OF CONTRAST-INDUCED NEPHROPATHY AFTER CORONARY ANGIOGRAPHY OR PERCUTANEOUS CORONARY INTERVENTION Poster Contributions Poster Area, South Hall A1 Sunday, April 03, 2016, 3:45 p.m.-4:30 p.m. Session Title: ACC.i2 Interventional Cardiology: Angiography and Interventional CT/MR Abstract Category: 2. ACC.i2 Interventional Cardiology: Angiography and Interventional CT/MR Presentation Number: 1224-165 Authors: Yong Liu, Hualong Li, Li-Wen Li, Ning Tan, Shiqun Chen, Pingyan Chen, Jianbin Zhao, Jiyan Chen, Department of Cardiology, Guangdong Cardiovascular Institute,Guangdong General Hospital, Guangzhou, People’s Republic of China, Department of Biostatistics, South China College of Cardiovascular Research, Guangzhou, People’s Republic of China
Background: It is uncertain if increased cystatin C level is a more reliable early marker of contrast-induced nephropathy (CIN) than serum creatinine (SCr).
Methods: We analyzed 1046 consecutive patients who underwent coronary angiography. Receiver operating characteristic curve (ROC) and multivariable analyses were performed to investigate the predictive value of the absolute and relative increases in cystatin C (Δcystatin C) in the 24-h post-procedure for different SCr -based CIN definitions and prognosis. The mean follow-up was 2.25 years. Results: CIN0.5, CIN0.3, and CIN25 occurred in 14, 38, and 103 patients, respectively. A ≥0.3 mg/dL or ≥10% increase in cystatin C levels occurred in 77 patients and 232 patients, respectively. The ROC analysis showed a good predictive value of baseline and post-procedural 24-h cystatin C for SCr -based CIN, but not Δcystatin C. In the multivariable regression analyses, Δcystatin C ≥0.3 mg/dL was an independent predictor of CIN0.5 and CIN25, but not CIN0.3, and Δcystatin C ≥10% was an independent predictor of CIN25, but not CIN0.5 and CIN0.3. Δcystatin C ≥0.3 mg/dL (Cox regression P = 0.063) and Δcystatin C ≥10%were not significantly associated with mortality; Δcystatin C did not predict mortality in the ROC analysis (C-statistic: 0.499, 0.507). Conclusions: Elevated cystatin C level is a reliable marker for CIN; however, the predictive value of cystatin C-based CIN varies with the definition of SCr-based CIN, without good prediction of long-term outcomes.
ACC.i2 Interventional Cardiology CYSTATIN C- AND CREATININE-BASED DEFINITIONS OF CONTRAST-INDUCED NEPHROPATHY AFTER CORONARY ANGIOGRAPHY OR PERCUTANEOUS CORONARY INTERVENTION Poster Contributions Poster Area, South Hall A1 Sunday, April 03, 2016, 3:45 p.m.-4:30 p.m. Session Title: ACC.i2 Interventional Cardiology: Angiography and Interventional CT/MR Abstract Category: 2. ACC.i2 Interventional Cardiology: Angiography and Interventional CT/MR Presentation Number: 1224-165 Authors: Yong Liu, Hualong Li, Li-Wen Li, Ning Tan, Shiqun Chen, Pingyan Chen, Jianbin Zhao, Jiyan Chen, Department of Cardiology, Guangdong Cardiovascular Institute,Guangdong General Hospital, Guangzhou, People’s Republic of China, Department of Biostatistics, South China College of Cardiovascular Research, Guangzhou, People’s Republic of China
Background: It is uncertain if increased cystatin C level is a more reliable early marker of contrast-induced nephropathy (CIN) than serum creatinine (SCr).
Methods: We analyzed 1046 consecutive patients who underwent coronary angiography. Receiver operating characteristic curve (ROC) and multivariable analyses were performed to investigate the predictive value of the absolute and relative increases in cystatin C (Δcystatin C) in the 24-h post-procedure for different SCr -based CIN definitions and prognosis. The mean follow-up was 2.25 years. Results: CIN0.5, CIN0.3, and CIN25 occurred in 14, 38, and 103 patients, respectively. A ≥0.3 mg/dL or ≥10% increase in cystatin C levels occurred in 77 patients and 232 patients, respectively. The ROC analysis showed a good predictive value of baseline and post-procedural 24-h cystatin C for SCr -based CIN, but not Δcystatin C. In the multivariable regression analyses, Δcystatin C ≥0.3 mg/dL was an independent predictor of CIN0.5 and CIN25, but not CIN0.3, and Δcystatin C ≥10% was an independent predictor of CIN25, but not CIN0.5 and CIN0.3. Δcystatin C ≥0.3 mg/dL (Cox regression P = 0.063) and Δcystatin C ≥10%were not significantly associated with mortality; Δcystatin C did not predict mortality in the ROC analysis (C-statistic: 0.499, 0.507). Conclusions: Elevated cystatin C level is a reliable marker for CIN; however, the predictive value of cystatin C-based CIN varies with the definition of SCr-based CIN, without good prediction of long-term outcomes.