[Cystatin C as a mortality predictor in a hypertensive population in Extremadura, Spain]

Abstract

Background and objectives: Cystatin C has proven to be a useful parameter to evaluate renal and cardiovascular risk. Nevertheless, there are scanty reports on the utility of this test in the Spanish population. We performed a survey in a group of patients followed up in Primary Care settings.

Material and methods: Prospective follow up of Primary Care attended patients recruited in 2008 and the first half of 2009. The sample included 142 subjects (mean age 64.2±14.6 years, 59.2% men). In all cases, cystatin C was determined and glomerular filtration rate (GFR) was estimated through the Hoek formula. Serum creatinine was also quantified as it was GFR estimated using CKD-EPI equation. The primary objective was a combination of death and major cardiovascular events incidence.

Results: There were 29 events registered (4 of them were deaths) and 9 non cardiovascular deaths. The odds ratio for the primary objective was 5.74 for the last quartile of cystatin C distribution (>1mg/l) (P=.002), while it was 6.44 for cystatin C derived GFR (P=.008) and 5.59 for CKD-EPI estimated GFR (P=.002, Mantel-Haenszel test).

Conclusions: Cystatin C showed a good association with general mortality and the incidence of cardiovascular events in the Spanish population. Nevertheless, it was not better than the observed relationship with GFR, estimated from creatinine.

Keywords: Cardiovascular risk; Cistatina C; Cystatin C; Filtrado glomerular; Función renal; Glomerular filtration rate; Renal function; Riesgo cardiovascular.