ABC | Volume 111, Nº6, December 2018

Original Article Einwoegerer & Domingueti Cystatin C and cardiovascular event or mortality Arq Bras Cardiol. 2018; 111(6):796-807 Table 4 – Results of selected studies Author/Year Result Sai et al., 2016 19 Proportion of patients with cystatin C levels> 0.637 mg/L who developed fatal or non-fatal cardiovascular events was higher than in patients with cystatin C < 0.637 mg/L [22 (15.9%) x 7 (5, 0%), p = 0.0025]. Risk of fatal or non - fatal cardiovascular events in patients with cystatin C levels > 0.637 mg/L was greater than in patients with cystatin levels < 0.637 mg/L [(univariate) HR = 1.37 (1.10 - 1.66), p = 0.004; HR (multivariate) = 1.30 (1.01 - 1.63), p = 0.0038]. Bansal et al., 2016 15 Risk of left ventricle hypertrophy was higher in patients with GFR between 60 and 75 ml/min/1.73 m 2 than in those with GFR > 90 ml/min/1.73 m 2 [(univariate) HR = 10.12 (5.22 – 15.02), p < 0.001; HR (multivariate analysis) = 5.63 (0.90 - 10.36), p = 0.02] Risk of left ventricular hypertrophy was higher in patients with GFR between 76 and 90 mL/min/1.73m 2 than in those with GFR> 90 mL/min/1.73 m 2 [HR (univariate analysis) = 3.48 (1, 29 - 5.68), p = 0.002]. Abid et al., 2016 7 Patients who developed non-fatal cardiovascular events showed higher levels of cystatin C compared to patients who did not develop these events (1.19 ± 0.4 mg/L x 1.01 ± 0.35 mg/L, p = 0.01) Patients who developed fatal cardiovascular events showed higher levels of cystatin C compared to patients who did not develop these events (1.21 ± 0.36 mg/L x 0.96 ± 0.27 mg/L, p = 0.03) Survival of patients with cystatin C levels < 1.2 mg/L was higher than in patients with cystatin levels > 1.2 mg/L (p < 0.01). Woitas et al., 2013 18 Patients with CAD showed higher levels of cystatin C than the control group (1.02 ± 0.44 mg/L x 0.92 ± 0.26 mg/L, p = 0.065 Risk of cardiovascular death and death from any cause of fourth quartile patients was higher than that of first quartile patients [HR (univariate) = 4.82 (3.69 - 6.29), p < 0.001; HR (multivariate) = 2.05 (1.48 - 2.84), p < 0.001]. Risk of cardiovascular death and death from any cause of third quartile patients was higher than that of first quartile patients [HR (univariate) = 2.11 (1.58 - 2.81), p < 0.001; HR (multivariate) = 1.20 (0.88 - 1.65), p < 0.243]. Dupont et al., 2012 8 Risk of death from any cause and non-fatal cardiovascular event of patients in the fourth quartile was higher than in patients in the first quartile (p = 0.002). Gao et al., 2011 21 Patients who developed fatal or non-fatal cardiovascular events showed higher levels of cystatin C compared to patients who did not develop these events (1.63 ± 0.81 mg/L x 0.91 ± 0.27 mg/L, p = 0.001) Risk of fatal or non-fatal cardiovascular events in patients with cystatin C levels> 0,9 mg/L was higher than in patients with cystatin levels < 0.9 mg/L [(univariate) HR = 3.58 (2.61 - 4.82), p = 0.033; HR (multivariate) = 7.10 (3.36 – 23.75), p = 0,006]. Keller et al., 2009 17 Patients with cardiovascular death had higher levels of cystatin C than patients without cardiovascular death [0.94 (0.79 - 1.08 x 0.79 (0.70 - 0.90), p < 0.001]. Risk of cardiovascular death of patients in the fourth quartile was higher than in patients in the other quartiles [OD (univariate) = 3.87 (2.33-6.42), p < 0.001; OD (multivariate) = 1.86 (0.90-3.81), p = 0.09]. Gao et al., 2009 22 Patients with AMI and unstable angina had higher levels of cystatin C than the control group (2873.55 ± 1148.48 ng/mL x 1509.99 ± 408.65 ng/mL, p < 0.01 and 2013.83 ± 633.85 ng/mL x 1509.99 ± 408.65 ng/mL, p < 0.05, respectively). Patients with AMI and unstable angina had higher levels of cystatin C than the patients with stable angina (2873.55 ± 1148.48 ng/mL x 1348.41 ± 369.62 ng/mL, p < 0.01 and 2013.83 ± 633.85 ng/mL x 1348.41 ± 369.62 ng/mL, p < 0.01, respectively). Patients with AMI had higher levels of cystatin C than the patients with stable angina (2873.55 ± 1148.48 ng/mL x 2013.83 ± 633.85 ng/mL, p < 0.05). Patients who developed fatal or non-fatal cardiovascular events showed higher levels of cystatin C compared to patients who did not develop these events (2356,73 ± 897,64 ng/L x 1469.51 ± 574.83 ng/L, p = 0.006) Alehagen et al., 2009 20 Risk of cardiovascular death of fourth quartile patients was higher than that of first quartile patients [HR (univariate analysis) = 3.61 (1.81 – 7.14)]. Acuna et al., 2009 16 The proportion of patients with cystatin C levels > 0.95 mg/L who had cardiovascular death was higher than that of patients with cystatin C levels ≤ 0.95 mg/L [16 (27.1%) x 6 (7.8%), p = 0.01]. The proportion of patients with cystatin C levels> 0.95 mg/L who develop HF was higher than that of patients with cystatin C levels ≤ 0.95 mg/L [22 (40.7%) x 6 (7.5%), p = 0.01]. Koenig et al., 2007 24 Each increase of 0.18 mg/L cystatin C was associated with an increased risk of cardiovascular death [OD = 1.42 (1.30 -1.54)], death from any cause [OD = 1.33 1.25-1.40)], HF [OD = 1.28 (1.17-1.40)], stroke [OD = 1.22 (1.08-1.38)] and AMI [OD = 1.20 (1.06-1.36)]. Patients with high levels of cystatin C had more adverse events than those with reduced levels of cystatin C (p < 0.001). Ix et al., 2007 23 Risk of death from any cause of fourth quartile patients was higher than that of first quartile patients [HR (univariate) = 5,7 (3,1 - 10,5), p < 0.001; HR (multivariate) = 3,6 (1,8 - 7,0), p < 0.001]. Risk of cardiovascular events of fourth quartile patients was higher than that of first quartile patients [HR (univariate) = 3.8 (2.1 – 6.9), p < 0.001; HR (multivariate) = 2.0 (1.0 – 3.8), p < 0.04]. Risk of CHF in patients in the fourth quartile was higher than in patients in the first quartile [HR (univariate) = 6.1 (2.5 - 14.5), p = 0.001; HR (multivariate) = 2.6 (1.0 - 6.9), p = 0.05]. CAD: Coronary artery disease; AMI: Acute Myocardial Infarction; GFR: Glomerular filtration rate; HR: Hazard Ratio. 802