Author + information
- Simon Correa Gaviria,
- David Morrow,
- Eugene Braunwald,
- Rich Davies,
- Erica Goodrich,
- Sabina Murphy,
- Christopher Cannon and
- Michelle O'Donoghue
Background: Cystatin C (Cys-C) is a marker of renal function that has shown prognostic value across different patient populations. The incremental value of Cys-C beyond established cardiac and renal biomarkers remains incompletely explored.
Methods: SOLID-TIMI 52 randomized patients <30 days post ACS to darapladib or placebo. Association between Cys-C and long-term risk (median f/u 2.5y) was assessed in 4,965 individuals with Cox models adjusting for clinical variables, treatment arm, creatinine, hsTnI, hsCRP, BNP, and the cardiorenal marker fibroblast growth factor-23 (FGF-23).
Results: Cys-C was strongly correlated with creatinine (r=0.60) and eGFR (r= −0.68), moderately correlated with FGF-23 (r=0.39), and weakly correlated with BNP (r=0.28), hsCRP (r=0.17) and hsTnI (r=0.062) (all P<0.001). After adjustment including creatinine (Fig 1A), Cys-C concentration in the top quartile was associated with approximately a 2-fold higher risk of HF hospitalization (HR 2.57; 95% CI 1.42, 4.64), and CV death or HF (HR 1.89; 95% CI 1.23, 2.89). Cys-C was also associated with increased risk of CV death, MI or stroke (HR 1.39; 95% CI 1.03, 1.86). In stratified analyses, Cys-C provided incremental prognostic information to other markers including BNP (Fig 1B) and FGF-23 (Fig 1C).
Conclusions: Cys-C is strongly associated with the risk of adverse outcomes in patients after ACS. This relationship is independent of established biomarkers, including creatinine, hsTnI, hsCRP, BNP and FGF-23.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Traditional and Novel Factors Used to Assess the Risk of, and Used for the Treatment of, Coronary Artery Disease
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1126-317
- 2017 American College of Cardiology Foundation