Cystatin-C and mortality in elderly persons with heart failure
Key result
Cystatin-C outperforms creatinine, linked to ~60% higher mortality risk in elderly HF.
- HR 1.60
- 95% CI 1.32-1.94
- n=279
Why the study?
Renal function is an important prognostic factor in HF, but creatinine may be insensitive for detecting renal insufficiency in elderly patients.
Population
279 elderly persons with prevalent heart failure
Comparison
Cystatin-C vs creatinine as predictors of mortality
Design
Cohort study
Follow-up
Median 6.5 years
Authors
Discussion
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Implication
Cohort study reveals cystatin-C strongly predicts mortality in elderly heart failure patients, suggesting superior kidney assessment compared with creatinine.
Key Points
- To evaluate serum cystatin-C as a predictor of mortality in elderly individuals with heart failure and compare its prognostic utility against creatinine.
- Cohort analysis of 279 Cardiovascular Health Study participants with prevalent heart failure.
- Serum cystatin-C and creatinine levels were measured at baseline, with mortality outcomes followed over a median of 6.5 years.
- Each 1-SD increase in cystatin-C (0.35 mg/l) was associated with a 31% higher adjusted mortality risk (95% CI 20% to 43%, p < 0.001), compared to a 17% increase per 1-SD of creatinine (95% CI 1% to 36%, p = 0.04).
- In a combined multivariable model, cystatin-C remained strongly associated with mortality (HR 1.60, 95% CI 1.32 to 1.94), whereas creatinine showed an inverse association (HR 0.73, 95% CI 0.57 to 0.95).
Study Design
Type
Cohort (n=279)
PICO
P
Population
279 elderly participants with prevalent heart failure and measures of serum cystatin-C and creatinine, followed for a median of 6.5 years.
E
Exposure / Comparator
Cystatin-C vs Creatinine
O
Primary Outcome
mortality — HR 1.60 (1.32-1.94)
Main Result
Hazard Ratio: 1.6 (95% CI 1.32–1.94)
Cite This Study
Shlipak et al. (2005) conducted a cohort in heart failure (n=279). Cystatin-C vs. Creatinine was evaluated on mortality (HR 1.60, 95% CI 1.32-1.94). In elderly persons with heart failure, cystatin-C was a stronger predictor of mortality than creatinine, remaining independently associated with elevated mortality risk (HR 1.60; 95% CI 1.32-1.94).