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Estimated glomerular filtration rate by serum creatinine (eGFRCr) is a measure of renal function and is used to predict prognosis in heart failure (HF) patients; however, this measure is influenced by some non-renal factors. Cystatin C has emerged as a novel serum measure of renal function, and is less affected by muscle mass. Therefore, we hypothesized that body mass index influences the predictive ability of eGFRCr and cystatin C for worse prognosis differently in HF patients.
Patients admitted for HF (n = 171) were evaluated using eGFRCr and cystatin C. Cohorts were divided into 3 groups according to tertile of BMI (low-, middle-, and high-BMI groups). The endpoint was mortality and/or HF hospitalization, and all cohorts were followed up for median of
The mean eGFRCr and cystatin C concentrations were 53.3 ml/min/1.73 m2 and 1.15 mg/L, respectively. Correlation analysis was performed between eGFRCr and 1/cystatin c for all cohorts and tertiles, and we found a significant positive correlation between eGFRCr and 1/ cystatin C in all cohorts (r = 0.70, P < 0.001). This significant correlation was observed in all tertiles; however, the correlation was the weakest in the low-BMI tertile (r = 0.60, P < 0.001) compared to that of the middle-BMI (r = 0.73, P < 0.001) and high-BMI groups (r = 0.74, P < 0.001). In receiver operating characteristic curve analysis, area under the curve (AUC) for predicting worse prognosis was not significantly different in the middle- (0.77 vs. 0.78, P = 0.74) and high-BMI groups (0.74 vs. 0.73, P = 0.88). However, in the low-BMI group, the AUC of cystatin C was significantly higher than that for eGFRCr for predicting worse prognosis (0.83 vs. 0.66, P = 0.047)
Prediction of prognosis in HF patients by cystatin C and eGFRCr is influenced by BMI. Cystatin C may be an important renal function indicator of the prediction of prognosis in HF patients, especially in those with low-BMI.
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Lessons Learned from Acute Decompensated Heart Failure
Abstract Category: 15. Heart Failure: Clinical
Presentation Number: 1175-284
- 2013 American College of Cardiology Foundation