Department of Cardiology, First Affiliated Hospital of Guangxi University of Science and Technology, Liuzhou, Guangxi, China (mainland).
Department of Cardiology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China (mainland).
Med Sci Monit. 2020 Feb 16;26:e919422. doi: 10.12659/MSM.919422.
BACKGROUND The aim of this study was to investigate the association between cystatin C and cardiac function and long-term prognosis in patients with chronic heart failure (CHF). MATERIAL AND METHODS We selected 418 CHF patients admitted to our hospital as subjects. Patients were divided into 3 groups according to the cystatin C level (Quantile 1 group: 0.65-1.04 mg/L, Quantile 2 group: 1.05-1.35 mg/L, and Quantile 3 group: 1.36-7.84 mg/L), and patients were followed up for 5 years. We used odds ratio (OR) and 95% confidence interval (CI) to compare the results. RESULTS The cystatin C and NT-ProBNP level in the cardiac function grade (NYHA) class IV group were higher than those in the class III group (P<0.05). Pearson correlation analysis showed that there was a positive correlation between cystatin C and NT-ProBNP log₁₀ transform in CHF patients (r=0.411). During 5-year follow-up, 231 patients died and the 5-year all-cause mortality rate was 55.26% (231/418). There was a significant difference in 5-year all-cause mortality among the 3 groups (P for trend=0.010). After adjusting for potential confounders by multivariate regression analysis, the Quantile 2 group vs. Quantile 1 group were OR=0.83, 95% CI 0.51 to 1.35, P=0.448, and the Quantile 3 group vs. Quantile 1 group were OR=1.71, 95% CI. 1.04 to 2.82, P=0.034. Curve fitting showed that cystatin C was positively correlated with 5-year all-cause mortality in CHF patients. CONCLUSIONS Cystatin C was positively correlated with cardiac function and NT-ProBNP in CHF patients. Cystatin C could be used as a serological index to evaluate the long-term prognosis of CHF patients.
本研究旨在探讨胱抑素 C 与慢性心力衰竭（CHF）患者心功能及长期预后的关系。
选取我院收治的 418 例 CHF 患者为研究对象。根据胱抑素 C 水平将患者分为 3 组（第 1 分位组：0.65-1.04mg/L，第 2 分位组：1.05-1.35mg/L，第 3 分位组：1.36-7.84mg/L），并进行 5 年随访。采用比值比（OR）及 95%置信区间（CI）比较结果。
心功能（NYHA）分级Ⅳ级组的胱抑素 C 和 NT-ProBNP 水平高于Ⅲ级组（P<0.05）。Pearson 相关分析显示，CHF 患者胱抑素 C 与 NT-ProBNP log₁₀ 呈正相关（r=0.411）。随访 5 年，231 例患者死亡，5 年全因死亡率为 55.26%（231/418）。3 组间 5 年全因死亡率差异有统计学意义（趋势 P=0.010）。多因素回归分析校正潜在混杂因素后，第 2 分位组与第 1 分位组比较，OR=0.83，95%CI 0.511.35，P=0.448；第 3 分位组与第 1 分位组比较，OR=1.71，95%CI 1.042.82，P=0.034。曲线拟合显示，CHF 患者胱抑素 C 与 5 年全因死亡率呈正相关。
胱抑素 C 与 CHF 患者的心功能和 NT-ProBNP 呈正相关。胱抑素 C 可作为评估 CHF 患者长期预后的血清学指标。
