Background: Renal function is closely related to cardiac function and an important prognostic marker in heart failure. Objective: We aimed to test the prognostic value of cystatin C (cysC)-derived estimated glomerular filtration rates (eGFR) in comparison with eGFRs from creatinine solely based equations in patients with acute heart failure (AHF). Methods: This study included 262 patients (65.8 ± 14.9 years old, 126 male) with AHF. Prognostic value of the eGFRs, from cysC-based equations chronic kidney disease epidemiology collaboration (CKD-EPI-cysC and CKD-EPI-creatinine [cr]-cysC equations) were compared with eGFRs calculated from serum creatinine levels only (Modification of Diet in Renal Disease [MDRD]-4 and CKD-EPI-cr equations). Prognosis was evaluated with the composite of all-cause mortality and hospitalization for heart failure within 1 year. Results: During the follow-up period (mean follow-up period, 264.0 ± 136.1 days), 67 (25.6%) events occurred. Estimated GFR using CKD-EPI-cysC was the best for predicting 1-year outcome using receiver operating characteristic curve analysis (area under curve 0.585, 0.607, 0.669, and 0.652 for eGFRs from MDRD-4, CKD-EPI-cr, CKD-EPI-cysC, and CKD-EPI-cr-cysC respectively). The Kaplan-Meier survival curve analysis showed that only the eGFRs classification from the equations based on cysC significantly predicted 1-year outcome in patients with AHF. Conclusions: Estimated GFRs calculated with cysC predicted the prognosis more accurately in patients with AHF than the eGFRs from creatinine only equations.
Cardiorenal Med

中文翻译：

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胱抑素 C 衍生的估计肾小球滤过率对急性心力衰竭患者的预后价值。

背景：肾功能与心功能密切相关，是心力衰竭的重要预后标志物。目的：我们旨在测试半胱氨酸蛋白酶抑制剂 C (cysC) 衍生的估计肾小球滤过率 (eGFR) 与仅基于肌酐方程的 eGFR 在急性心力衰竭 (AHF) 患者中的预后价值。方法：该研究包括 262 名 AHF 患者（65.8 ± 14.9 岁，126 名男性）。来自基于 cysC 的慢性肾病流行病学合作方程（CKD-EPI-cysC 和 CKD-EPI-肌酐 [cr]-cysC 方程）的 eGFR 的预后价值与仅从血清肌酐水平计算的 eGFR（饮食的修改）进行了比较肾病 [MDRD]-4 和 CKD-EPI-cr 方程）。预后用全因死亡率和 1 年内心力衰竭住院的复合评估。结果：在随访期间（平均随访期，264.0 ± 136.1 天），发生了 67 (25.6%) 次事件。使用 CKD-EPI-cysC 估计的 GFR 是使用受试者工作特征曲线分析预测 1 年结果的最佳结果（MDRD-4、CKD-EPI-cr、CKD- EPI-cysC 和 CKD-EPI-cr-cysC）。Kaplan-Meier 生存曲线分析表明，只有基于 cysC 的方程中的 eGFR 分类才能显着预测 AHF 患者的 1 年结果。结论：与仅用肌酐方程计算的 eGFR 相比，使用 cysC 计算的估计 GFR 更准确地预测了 AHF 患者的预后。
心肾医学