Calero-Paniagua Ismael, Ruíz-Chicote Ana María, Nieto-Rodríguez José Antonio, Ruiz-Ribó María Dolores, Cortés Carmona Ana Belén
Servicio de Reumatología, Hospital Universitario de Salamanca, Salamanca, España.
Servicio de Medicina Interna, Hospital de Tomelloso, Tomelloso, Ciudad Real, España.
Med Clin (Barc). 2014 Dec 23;143(12):530-4. doi: 10.1016/j.medcli.2013.08.007. Epub 2013 Nov 9.
Cystatin C (cysC) is a prognostic marker in patients with hypertension, coronary heart disease and heart failure. The aim of this study was to determine the prognostic value of cysC levels obtained at the time of diagnosis in patients with venous thromboembolism (VTE).
Retrospective study of a cohort of 226 consecutive patients with VTE, followed for 6 months. Serum samples were obtained for the determination of cysC, creatinine, and the N-terminal fraction of the brain natriuretic peptide (NT-proBNP) at the time of diagnosis.
The highest discriminating power value of dying at 6 months for cysC was 1,175mg/dl (sensitivity 76%, specificity 65%, positive predictive value 26%, negative predictive value 94%). Above the cut-off, 17/48 patients died, versus 9/152 that had lower levels (odds ratio: 5.98, 95% confidence interval [95% CI]: 2.50-14.29, P<.001). The adjusted hazard ratio in a multivariate model was 3.76 (95% CI 1.46-9.66). The accuracy of this parameter was similar to that for creatinine (1.24mg/dl) but lower than the NT-proBNP (435pg/ml). Patients who exceeded the limit values of cysC and NT-proBNP together had no greater risk of death than those above NT-proBNP only (odds ratio: 9.43, 95% CI 3.90-22.81, P<.001). There was no value, which was significantly associated with bleeding episodes or recurrent thromboembolism.
CysC concentration at the time of diagnosis in VTE patients has prognostic value, which is similar to that of serum creatinine and lower than that of NT-proBNP.
