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Cystatin C is better than creatine for prognostic evaluation in heart failure patients
Session:
Posters (Sessão 4 - Écran 2) - Insuficiência cardíaca - estratificação de risco
Speaker:
Ana Filipa Mesquita Gerardo
Congress:
CPC 2023
Topic:
D. Heart Failure
Theme:
10. Chronic Heart Failure
Subtheme:
10.2 Chronic Heart Failure – Epidemiology, Prognosis, Outcome
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Filipa Gerardo; Inês Fialho; Mariana Passos; Carolina Mateus; Inês Miranda; Marco Beringuilho; Joana Lopes; Daniel Faria; David Roque
Abstract
<p style="text-align:center"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong>Title: </strong>Cystatin C is better than creatine for prognostic evaluation in heart failure patients</span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong>Background</strong>: Cardiac cachexia and sarcopenia are hallmarks of advanced heart failure. Using creatinine as a proxy for renal dysfunction in these patients has proven to underestimate renal dysfunction. </span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong>Purpose</strong>: To correlate kidney function biomarkers with clinical outcomes in heart failure patients. </span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong>Methods</strong>: We conducted a retrospective single center study during an 18-month time frame on hospitalized acute heart failure patients. Patients were included if they had an early post discharge appointment, within 2 weeks after discharge, and kidney function assessment (cystatin C, creatinine, and urea). <span style="background-color:white"><span style="color:#212529">Demographic, clinical, and laboratorial data was reviewed for all cases at discharge and post-discharge consult. The primary endpoint was heart failure decompensation and cardiovascular mortality in a 6-month follow-up period. </span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="color:#212529">Results</span></strong><span style="color:#212529">: A total of 171 electronic medical charts were reviewed. Of these, 57.31% (n=98) met the inclusion criteria. The primary endpoint was met by 32.61% (n=32) patients. At the post discharge appointment, <span style="background-color:white">multivariable logistic regression analysis showed that </span></span>Cystatin C <span style="background-color:white"><span style="color:#212529">(OR 4.00, 95% CI 1.132-14.138, p=0.03) </span></span>was the only biomarker independently associated with the primary outcome, whereas creatinine <span style="color:#212529">(OR 0.75, CI 0.26-2.16) and urea (OR 0.98, CI 0.97-1.01) showed no significant association</span>. Receiving operator characteristics (ROC) curve analysis of <span style="color:#212529">Glomerular Filtration Rate (GFR) using both Cystatin C and Creatinine (</span>AUC 0.717, CI 0.614-0.820) and GFR using cystatin C (AUC 0.710, CI 0.606-0.814) <span style="color:#212529">yielded a better prediction score </span>than GFR using creatinine alone (AUC 0.701, CI 0.595-0.807).</span></span><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"> </span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="color:#212529">Conclusion</span></strong><span style="color:#212529">: Cystatin C appears to correlate better to clinical outcomes in heart failure patients than creatinine. </span></span></span></p>
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