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Urinary Cystatin C Has Prognostic Value in Peripheral Artery Disease

Despite its association with adverse outcomes, peripheral artery disease (PAD) remains undertreated. Cystatin C is elevated in patients with renal disease and may be a marker of cardiovascular disease. We examined the prognostic ability of urinary Cystatin C (uCystatinC) in predicting adverse PAD-re...

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Autores principales: Li, Ben, Zamzam, Abdelrahman, Syed, Muzammil H., Jahanpour, Niousha, Jain, Shubha, Abdin, Rawand, Qadura, Mohammad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9313414/
https://www.ncbi.nlm.nih.gov/pubmed/35883416
http://dx.doi.org/10.3390/biom12070860
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author Li, Ben
Zamzam, Abdelrahman
Syed, Muzammil H.
Jahanpour, Niousha
Jain, Shubha
Abdin, Rawand
Qadura, Mohammad
author_facet Li, Ben
Zamzam, Abdelrahman
Syed, Muzammil H.
Jahanpour, Niousha
Jain, Shubha
Abdin, Rawand
Qadura, Mohammad
author_sort Li, Ben
collection PubMed
description Despite its association with adverse outcomes, peripheral artery disease (PAD) remains undertreated. Cystatin C is elevated in patients with renal disease and may be a marker of cardiovascular disease. We examined the prognostic ability of urinary Cystatin C (uCystatinC) in predicting adverse PAD-related events. In this prospective case-control study, urine samples were collected from patients with PAD (n = 121) and without PAD (n = 77). The cohort was followed for 2 years. uCystatinC was normalized to urinary creatinine (uCr) (uCystatinC/uCr; μg/g). The primary outcome was major adverse limb event (MALE; composite of vascular intervention (open or endovascular) or major limb amputation). The secondary outcome was worsening PAD status (drop in ABI ≥ 0.15). Multivariable Cox regression and Kaplan–Meier analyses were performed to assess the prognostic value of uCystatinC/uCr with regards to predicting MALE and worsening PAD status. Our analysis demonstrated that patients with PAD had significantly higher median [IQR] uCystatinC/uCr levels (24.9 μg/g [14.2–32.9] vs. 20.9 μg/g [11.1–27.8], p = 0.018). Worsening PAD status and MALE were observed in 39 (20%) and 34 (17%) patients, respectively. uCystatinC/uCr predicted worsening PAD status with a hazard ratio (HR) of 1.78 (95% CI 1.12–2.83, p = 0.015), which persisted after controlling for baseline demographic and clinical characteristics (adjusted HR 1.79 [95% CI 1.11–2.87], p = 0.017). Patients with high uCystatinC/uCr had a lower 2-year freedom from MALE (77% vs. 89%, p = 0.025) and worsening PAD status (63% vs. 87%, p = 0.001). Based on these data, higher uCystatinC/uCr levels are associated with adverse PAD-related events and have prognostic value in risk-stratifying individuals for further diagnostic vascular evaluation or aggressive medical management.
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spelling pubmed-93134142022-07-26 Urinary Cystatin C Has Prognostic Value in Peripheral Artery Disease Li, Ben Zamzam, Abdelrahman Syed, Muzammil H. Jahanpour, Niousha Jain, Shubha Abdin, Rawand Qadura, Mohammad Biomolecules Article Despite its association with adverse outcomes, peripheral artery disease (PAD) remains undertreated. Cystatin C is elevated in patients with renal disease and may be a marker of cardiovascular disease. We examined the prognostic ability of urinary Cystatin C (uCystatinC) in predicting adverse PAD-related events. In this prospective case-control study, urine samples were collected from patients with PAD (n = 121) and without PAD (n = 77). The cohort was followed for 2 years. uCystatinC was normalized to urinary creatinine (uCr) (uCystatinC/uCr; μg/g). The primary outcome was major adverse limb event (MALE; composite of vascular intervention (open or endovascular) or major limb amputation). The secondary outcome was worsening PAD status (drop in ABI ≥ 0.15). Multivariable Cox regression and Kaplan–Meier analyses were performed to assess the prognostic value of uCystatinC/uCr with regards to predicting MALE and worsening PAD status. Our analysis demonstrated that patients with PAD had significantly higher median [IQR] uCystatinC/uCr levels (24.9 μg/g [14.2–32.9] vs. 20.9 μg/g [11.1–27.8], p = 0.018). Worsening PAD status and MALE were observed in 39 (20%) and 34 (17%) patients, respectively. uCystatinC/uCr predicted worsening PAD status with a hazard ratio (HR) of 1.78 (95% CI 1.12–2.83, p = 0.015), which persisted after controlling for baseline demographic and clinical characteristics (adjusted HR 1.79 [95% CI 1.11–2.87], p = 0.017). Patients with high uCystatinC/uCr had a lower 2-year freedom from MALE (77% vs. 89%, p = 0.025) and worsening PAD status (63% vs. 87%, p = 0.001). Based on these data, higher uCystatinC/uCr levels are associated with adverse PAD-related events and have prognostic value in risk-stratifying individuals for further diagnostic vascular evaluation or aggressive medical management. MDPI 2022-06-21 /pmc/articles/PMC9313414/ /pubmed/35883416 http://dx.doi.org/10.3390/biom12070860 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Li, Ben
Zamzam, Abdelrahman
Syed, Muzammil H.
Jahanpour, Niousha
Jain, Shubha
Abdin, Rawand
Qadura, Mohammad
Urinary Cystatin C Has Prognostic Value in Peripheral Artery Disease
title Urinary Cystatin C Has Prognostic Value in Peripheral Artery Disease
title_full Urinary Cystatin C Has Prognostic Value in Peripheral Artery Disease
title_fullStr Urinary Cystatin C Has Prognostic Value in Peripheral Artery Disease
title_full_unstemmed Urinary Cystatin C Has Prognostic Value in Peripheral Artery Disease
title_short Urinary Cystatin C Has Prognostic Value in Peripheral Artery Disease
title_sort urinary cystatin c has prognostic value in peripheral artery disease
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9313414/
https://www.ncbi.nlm.nih.gov/pubmed/35883416
http://dx.doi.org/10.3390/biom12070860
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