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- Title
The potential of cystatin C as a predictive biomarker in pulmonary hypertension.
- Authors
Duan, Anqi; Huang, Zhihua; Zhao, Zhihui; Zhao, Qing; Jin, Qi; Yan, Lu; Zhang, Yi; Li, Xin; Zhang, Sicheng; Hu, Meixi; Gao, Luyang; An, Chenhong; Luo, Qin; Liu, Zhihong
- Abstract
Background: Cystatin C is a novel biomarker to identify renal dysfunction and cardiovascular risk. Objective: The aim of this study was to investigate the role of cystatin C in non-invasive risk prediction in a large cohort of patients with pre-capillary pulmonary hypertension (PH). Method: We retrospectively analyzed pre-capillary PH patients with available cystatin C and hemodynamic data derived from right heart catheterization. Results: A total of 398 consecutive patients with confirmed pre-capillary PH were recruited from Fuwai Hospital between November 2020 and November 2021. Over a median duration of 282 days, 72 (18.1%) of these patients experienced clinical worsening. Cystatin C levels significantly correlated with cardiac index (r = -0.286, P < 0.001), mixed venous oxygen saturation (r = -0.216, P < 0.001), and tricuspid annular plane systolic excursion (r = -0.236, P < 0.001), and high cystatin C levels independently predicted a poor prognosis after adjusting potential confounders in different models (all P < 0.05). A three-group non-invasive risk model was constructed based on the combined assessment of the cystatin C and WHO-FC using dichotomous cut-off value. Those patients with higher cystatin C (≥ 1.0 mg/L) and a worse WHO-FC experienced the highest risk of endpoint occurrence. The predictive capacity of this model was comparable to that of an existing invasive risk stratification model (area under curve: 0.657 vs 0.643, P = 0.619). Conclusions: Cystatin C levels were associated with disease severity and prognosis in patients with pre-capillary PH. A combination of high cystatin C and advanced WHO-FC identifies patients at particularly high risk of clinical deterioration.
- Subjects
CYSTATIN C; PULMONARY hypertension; OXYGEN saturation; CLINICAL deterioration; CARDIAC catheterization; TETRALOGY of Fallot
- Publication
BMC Pulmonary Medicine, 2023, Vol 23, Issue 1, p1
- ISSN
1471-2466
- Publication type
Article
- DOI
10.1186/s12890-023-02595-1