Research Paper|Volume 10, Issue 3|pp 425—433

Can Serum Cystatin C predict long-term survival in cardiac surgery patients?

Valentina Rovella¹, Giulia Marrone^1,², Mariarita Dessì³, Michele Ferrannini¹, Nicola Toschi^4,⁵, Antonio Pellegrino⁶, Maurizio Casasco⁷, Nicola Di Daniele¹, Annalisa Noce¹

¹Department of Medicine, Hypertension and Nephrology Unit, University Hospital Tor Vergata, Rome 00133, Italy
²PhD School of Applied Medical-Surgical Sciences, University of Rome Tor Vergata, Rome 00133, Italy
³Department of Laboratory Medicine, University Hospital Tor Vergata, Rome, 00133, Italy
⁴Department of Biomedicine and Prevention, Medical Physics Section, University of Rome Tor Vergata, Rome 00133, Italy
⁵Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging and Harvard Medical School, Boston, MA 02129, USA
⁶Department of Cardiac Surgery, University Hospital Tor Vergata, Rome 00133, Italy
⁷Federazione Medico Sportiva Italiana, Rome 00196, Italy

Received: January 9, 2018Accepted: March 16, 2018Published: March 27, 2018

https://doi.org/10.18632/aging.101403

Copyright: © 2018 Rovella et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Renal dysfunction is a risk factor for morbidity and mortality in cardiac surgery patients. Serum Cystatin C (sCysC) is a well-recognized marker of early renal dysfunction but few reports evaluate its prognostic cardio-vascular role. The aim of the study is to consider the prognostic value of sCysC for cardiovascular mortality. Four hundred twenty-four cardiac-surgery patients (264 men and 160 women) were enrolled. At admission, all patients were tested for renal function and inflammatory status. Patients were subdivided in subgroups according to the values of the following variables: sCysC, serum Creatinine (sCrea), age, high sensitivity-C Reactive Protein, fibrinogen, surgical procedures and Kaplan-Meier cumulative survival curves were plotted. The primary end-point was cardiovascular mortality. In order to evaluate the simultaneous independent impact of all measured variables on survival we fitted a multivariate Cox-Proportional Hazard Model (CPHM). In Kaplan-Meier analysis 124 patients (29.4%) reached the end-point. In multivariate CPHM, the only significant predictors of mortality were sCysC (p<0.00001, risk ratio: 1.529, CI: 1.29-1.80) and age (p=0.039, risk ratio: 1.019, CI: 1.001-1.037). When replacing sCysC with sCrea, the only significant predictor of mortality was sCrea (p=0.0026; risk ratio 1.20; CI: 1.06-1.36). Increased levels of sCysC can be considered a useful biomarker of cardiovascular mortality in cardiac-surgery patients.