BACKGROUND: The estimated glomerular filtration rate (eGFR) independently predicts cardiovascular death or myocardial infarction (MI) and can be estimated by creatinine and cystatin C concentrations. We evaluated 2 different cystatin C assays, alone or combined with creatinine, in patients with acute coronary syndrome. METHODS: We analyzed plasma cystatin C, measured with assays from Gentian and Roche, and serum creatinine in 16 279 patients from the PLATelet Inhibition and Patient Outcomes (PLATO) trial. We evaluated Pearson correlation and agreement (Bland-Altman) between methods, as well as prognostic value in relation to cardiovascular death or MI during 1 year of follow up by multivariable logistic regression analysis including clinical variables, biomarkers, c-statistics, and relative integrated discrimination improvement (IDI). RESULTS:Median cystatin C concentrations (interquartile intervals) were 0.83 (0.68-1.01) mg/L (Gentian) and 0.94 (0.80-1.14) mg/L (Roche). Overall correlation was 0.86 (95% CI 0.85-0.86). The level of agreement was within 0.39 mg/L (2 SD) (n = 16 279). The areas under the curve (AUCs) in the multivariable risk prediction model with cystatin C (Gentian, Roche) or Chronic Kidney Disease Epidemiology Collaboration eGFR (CKD-EPI) added were 0.6914, 0.6913, and 0.6932. Corresponding relative IDI values were 2.96%, 3.86%, and 4.68% (n = 13 050). Addition of eGFR by the combined creatinine-cystatin C equation yielded AUCs of 0.6923 (Gentian) and 0.6924 (Roche) with relative IDI values of 3.54% and 3.24%. CONCLUSIONS: Despite differences in cystatin C concentrations, overall correlation between the Gentian and Roche assays was good, while agreement was moderate. The combined creatinine-cystatin C equation did not outperform risk prediction by CKD-EPI.
RCT Entities:
BACKGROUND: The estimated glomerular filtration rate (eGFR) independently predicts cardiovascular death or myocardial infarction (MI) and can be estimated by creatinine and cystatin C concentrations. We evaluated 2 different cystatin C assays, alone or combined with creatinine, in patients with acute coronary syndrome. METHODS: We analyzed plasma cystatin C, measured with assays from Gentian and Roche, and serum creatinine in 16 279 patients from the PLATelet Inhibition and Patient Outcomes (PLATO) trial. We evaluated Pearson correlation and agreement (Bland-Altman) between methods, as well as prognostic value in relation to cardiovascular death or MI during 1 year of follow up by multivariable logistic regression analysis including clinical variables, biomarkers, c-statistics, and relative integrated discrimination improvement (IDI). RESULTS: Median cystatin C concentrations (interquartile intervals) were 0.83 (0.68-1.01) mg/L (Gentian) and 0.94 (0.80-1.14) mg/L (Roche). Overall correlation was 0.86 (95% CI 0.85-0.86). The level of agreement was within 0.39 mg/L (2 SD) (n = 16 279). The areas under the curve (AUCs) in the multivariable risk prediction model with cystatin C (Gentian, Roche) or Chronic Kidney Disease Epidemiology Collaboration eGFR (CKD-EPI) added were 0.6914, 0.6913, and 0.6932. Corresponding relative IDI values were 2.96%, 3.86%, and 4.68% (n = 13 050). Addition of eGFR by the combined creatinine-cystatin C equation yielded AUCs of 0.6923 (Gentian) and 0.6924 (Roche) with relative IDI values of 3.54% and 3.24%. CONCLUSIONS: Despite differences in cystatin C concentrations, overall correlation between the Gentian and Roche assays was good, while agreement was moderate. The combined creatinine-cystatin C equation did not outperform risk prediction by CKD-EPI.
Authors: Patrizia Natale; Suetonia C Palmer; Valeria M Saglimbene; Marinella Ruospo; Mona Razavian; Jonathan C Craig; Meg J Jardine; Angela C Webster; Giovanni Fm Strippoli Journal: Cochrane Database Syst Rev Date: 2022-02-28
Authors: Johanna Helmersson-Karlqvist; Miklos Lipcsey; Johan Ärnlöv; Max Bell; Bo Ravn; Alain Dardashti; Anders Larsson Journal: Sci Rep Date: 2021-03-15 Impact factor: 4.379
Authors: Damilola D Adingupu; Helena U Westergren; Santosh Dahgam; Ann-Cathrine Jönsson-Rylander; Juuso Blomster; Per Albertsson; Elmir Omerovic; Sara Svedlund; Li-Ming Gan Journal: Oncotarget Date: 2017-06-16