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Elevated serum cystatin C level is an independent predictor of contrast-induced nephropathy and adverse outcomes in patients with peripheral artery disease undergoing endovascular therapy

 Gwang Sil Kim  ;  Young Guk Ko  ;  Dong Ho Shin  ;  Jung Sun Kim  ;  Byeong Keuk Kim  ;  Donghoon Choi  ;  Myeong Ki Hong  ;  Yangsoo Jang 
 JOURNAL OF VASCULAR SURGERY, Vol.61(5) : 1223-1230, 2015 
Journal Title
Issue Date
Aged ; Angiography/adverse effects* ; Angioplasty/adverse effects* ; Arterial Occlusive Diseases/blood ; Arterial Occlusive Diseases/diagnostic imaging* ; Arterial Occlusive Diseases/therapy* ; Biomarkers/blood* ; Contrast Media/adverse effects* ; Creatinine/blood ; Cystatin C/blood* ; Female ; Humans ; Intermittent Claudication/blood ; Intermittent Claudication/diagnostic imaging ; Intermittent Claudication/therapy ; Ischemia/blood ; Ischemia/diagnostic imaging* ; Ischemia/therapy* ; Kidney Function Tests ; Leg/blood supply* ; Male ; Middle Aged ; Proportional Hazards Models ; Renal Insufficiency/blood* ; Renal Insufficiency/chemically induced* ; Retrospective Studies ; Risk Factors
OBJECTIVE: The aim of this study was to investigate the association of serum cystatin C levels with contrast-induced nephropathy (CIN) and adverse clinical events in patients with peripheral artery disease (PAD). METHODS: A total of 240 PAD patients who received endovascular therapy were included in this retrospective analysis. Serial serum levels of creatinine and cystatin C before and within 48 hours of endovascular therapy were evaluated for the incidence of CIN. The relationship between serum cystatin C levels and the incidence of major adverse events, defined as a composite of all-cause death, myocardial infarction, stroke, amputation, and target vessel revascularization, was investigated. RESULTS: The incidence of CIN increased from 1.7% to 27.9%, depending on the quartile of baseline cystatin C level. Baseline serum cystatin C level (area under the curve of the receiver operating characteristic curve, 0.757; 95% confidence interval [CI], 0.696-0.735) predicted the incidence of CIN better than baseline serum creatinine level (area under the curve, 0.629; 95% CI, 0.563-0.691; P < .001). An elevated baseline cystatin C level was an independent predictor of CIN (hazard ratio, 14.37; 95% CI, 4.11-50.19; P < .001) and major adverse events in patients with PAD (hazard ratio, 2.57; 95% CI, 1.28-5.17; P = .008). CONCLUSIONS: We found elevated baseline cystatin C level to be an independent risk factor for CIN and a predictor of all-cause mortality and major adverse events in patients with PAD undergoing endovascular therapy.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kim, Gwang Sil(김광실)
Kim, Byeong Keuk(김병극) ORCID logo https://orcid.org/0000-0003-2493-066X
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
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