| Article ID | Journal | Published Year | Pages | File Type |
|---|---|---|---|---|
| 3465839 | European Journal of Internal Medicine | 2016 | 4 Pages |
•Cystatin C predicted the risk of non-CVD and CVD death both in men and women.•After additional adjustments, predictive value of cystatin C remained significant.•CKD-EPIcr-cys predicted the risk of non-CVD deaths in women.
BackgroundCystatin C is claimed to be superior to creatinine-based estimates of glomerular filtration rate (eGFRcr). The purpose of the study is to analyze whether cystatin C, creatinine, and/or estimated glomerular filtration rates (eGFR) predicted cardiovascular and/or non-cardiovascular deaths among Finnish elderly.MethodsHazard ratios (HR) of cystatin C, creatinine and eGFRs for cardiovascular and non-cardiovascular deaths.ResultsDuring a 9-year follow-up, 275 died, 192 deaths were a result of cardiovascular disease. In age-adjusted analyses, cystatin C predicted the risk of non-cardiovascular and cardiovascular death in men (HR for 0.1-unit increase 1.12 [95% CI, 1.04–1.19] for non-CVD deaths and 1.18 [1.09–1.28] for CVD deaths) and women (1.14 [1.07–1.21] and 1.14 [1.06–1.22], respectively). CKD-EPIcr-cyc predicted the risk of CVD deaths in men (HR for 5-unit decrease 1.17 [1.09–1.25]) and women (1.09 [1.02–1.17]) and non-CVD deaths in women (1.07 [1.01–1.14]). Also, MDRD (HR for 5-unit decrease 1.16 [1.05–1.27]) and CKD-EPI (HR for 5-unit decrease 1.15 [1.05–1.25]) predicted CVD deaths among men. After additional adjustments, predictive value of cystatin C remained significant. Also, the predictive value of CKD-EPIcr-cys remained significant in non-CVD deaths among women.ConclusionCystatin C was clearly the best predictor for cardiovascular and non-cardiovascular deaths among Finnish elderly. Serum cystatin C is more accurate for clinical decision making than creatinine-based eGFR equations or the combined CKD-EPIcr-cys equation in persons older than 64 years.
