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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...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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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. |
format | Online Article Text |
id | pubmed-9313414 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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