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 1. Organização Pan Americana de Saúde. (OPAS-OMS). [Internet]. [Acesso em 2018 abr 10]. Disponível em: https://www.paho.org/bra/ index.php?option=com_content&view=article&id=5253:doencas- cardiovasculares&Itemid=839 2. DeBackerG,AmbrosioniE,Borch-JohnsenK,BrotonsC,CifkovaR,Dallongeville J, et al; European Society of Cardiology Committee for Practice Guidelines. European guidelines on cardiovascular disease prevention in clinical practice: third joint task force of European and other societies on cardiovascular disease preventioninclinicalpractive(constitutedbyrepresentativesofeightsocietiesand by invitedexperts).EurJCardiovascPrevRehabil.2003;10(4):S1-10. 3. Bi M, Huang Z, Li P, Cheng C, Huang Y, Chen W. The association between elevated cystatin C levels with myocardial infarction: a meta-analysis. Int J Clin Exp Med. 2015:8(11):20540-7. 4. Wang M, Zhang L, Yue R, You G, Zeng R. Significance of cystatin C for early diagnosis of contrast-induced nephropathy in patients undergoing coronary angiography. Med Sci Monit. 2016;22:2956-61. 5. Lameire N, Vanholder R, Biesen WV, Benoit D. Acute kidney injury in critically ill cancer patients: an update. Crit Care. 2016;20(1):209. 6. Bongartz LG, Cramer MJ, Braam B. The cardiorenal connection. Hypertension. 2004;43(4):e14. 7. AbidL,CharfeddineS,KammounS,TurkiM,AyediF.CystatinC:aprognostic marker after myocardial infarction in patients without chronic kidney disease. J Saudi Heart Assoc. 2016;28(3):144-51. 8. Dupont M, Wu Y, Hazen SL, Tang WH. Cystatin C identifies patients with stable chronic heart failure at increased risk for adverse cardiovascular events. Circ. Heart failure. 2012;5(5):602-9. 9. LiR,HaoP,ChenY,ZhangY.AssociationofcystatinC levelandcardiovascular prognosis for patients with preexisting coronary heart disease: a meta- analysis. Chin Sci Bulletin. 2014;59(5-6):539-45. 10. Bi M, Huang Z, Li P, Cheng C, Huang Y, Chen W. The association between elevated cystatin C levels with myocardial infarction: a meta-analysis. Int J Clin Exp Med. 2015;8(11):20540-7. 11. Lee M, Saver JL, Huang WH, Chow J, Chang KH, Ovbiagele B. Impact of elevated cystatin C level on cardiovascular disease risk in predominantly high cardiovascular risk populations: ameta-analysis. Circ Cardiovasc Qual Outcomes. 2010;3(6):675-83. 12. Luo J, Wang LP, Hu HF, Zhang L, Li YL, Ai LM, et al. Cystatin C and cardiovascular or all-cause mortality risk in the general population: a meta- analysis. Clin Chim Acta. 2015 Oct 23;450:39-45. 13. Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA Statement. PLoS Med. 2009;6(7):e1000097. 14. Wells GA, Shea B, O’Connell D, Peterson J, Welch V, Losos M, et al. The Newcastle–Ottawa Scale (NOS) for assessing the quality if nonrandomized studies in meta-analysis [Internet]. [Access in 2017 Sep 1]. Available from: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp 15. Bansal N, Lin F, Vittinghoff E, Peralta C, Lima J, Kramer H, et al. Estimated GFR and subsequent higher left ventricular mass in young and middle-aged adults with normal kidney function: the coronary artery risk development in young adults (CARDIA) study. Am J Kidney Dis. 2016;67(2):227-34. 16. García Acuña JM, González-Babarro E, Grigorian Shamagian L, Peña-Gil C, Vidal Pérez R, López-Lago AM, et al. Cystatin C provides more information than other renal function parameters for stratifying risk in patients with acute coronary syndrome. Rev Esp Cardiol. 2009;62(5):510-9. 17. KellerT,MartinaCM,LubosE,NicaudV,WildSP,RupprechtHJ,etal.Cystatin C and cardiovascular mortality in patients with coronary artery disease and normal or mildly reduced kidney function: results from the AtheroGene study. Eur Heart J. 2009;30(3):314-20. 18. Woitas RP, Kleber ME, Meinitzer A, Grammer TB, Silbernagel G, Pilz Stefan, et al. Cystatin C is independently associated with total and cardiovascular mortality in individuals undergoing coronary angiography. The Ludwigshafen Risk and Cardiovascular Health (LURIC) study. Atherosclerosis. 2013;229(2):541-8. References Conclusion The systematic review has shown that there is a significant association between high levels of cystatin C and the risk of cardiovascular events or mortality in subjects with normal renal function. The meta-analysis also demonstrated that there is a significant association between high levels of cystatin C and the risk of all-cause mortality. As individuals included in the studies had normal renal function, it is possible to conclude that the association between high levels of cystatin C and the risk of cardiovascular events or mortality does not depend on the presence of renal dysfunction assessed by serum creatinine‑based GFR. Therefore, cystatin C is a very interesting marker to assess the risk of cardiovascular events or mortality, especially in populations at risk of cardiovascular events or that already have some degree of cardiovascular impairment, and can complement the currently available markers. Author contributions Conception and design of the research, Acquisition of data, Analysis and interpretation of the data, Statistical analysis e Writing of the manuscript: Einwoegerer CF, Domingueti CP; Critical revision of the manuscript for intellectual content: Domingueti CP. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding There were no external funding sources for this study. Study Association This study is not associatedwith any thesis or dissertationwork. Ethics approval and consent to participate This article does not contain any studies with human participants or animals performed by any of the authors. 805