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Cystatin C and incident peripheral arterial disease events in the elderly: results from the Cardiovascular Health Study.

TitleCystatin C and incident peripheral arterial disease events in the elderly: results from the Cardiovascular Health Study.
Publication TypeJournal Article
Year of Publication2005
AuthorsO'Hare, AM, Newman, AB, Katz, R, Fried, LF, Stehman-Breen, CO, Seliger, SL, Siscovick, DS, Shlipak, MG
JournalArch Intern Med
Volume165
Issue22
Pagination2666-70
Date Published2005 Dec 12-26
ISSN0003-9926
KeywordsAged, Cohort Studies, Cystatin C, Cystatins, Female, Health Surveys, Humans, Longitudinal Studies, Male, Peripheral Vascular Diseases, Predictive Value of Tests, Risk Factors, ROC Curve, United States
Abstract<p><b>BACKGROUND: </b>The association of cystatin C, a novel marker of renal function, with risk for developing complications related to peripheral arterial disease (PAD) has not been examined.</p><p><b>METHODS: </b>We evaluated the hypothesis that a high cystatin C concentration is independently associated with future PAD events among 4025 participants in the Cardiovascular Health Study who underwent serum cystatin C measurement at the 1992-1993 visit and who did not have PAD at baseline. The association of cystatin C quintiles with time to first lower-extremity PAD procedure (bypass surgery, angioplasty, or amputation) was evaluated using multivariable proportional hazards models. Secondary analyses were conducted using quintiles of serum creatinine level and estimated glomerular filtration rate (eGFR).</p><p><b>RESULTS: </b>The annualized risk of undergoing a procedure for PAD was 0.43% per year among participants in the highest cystatin C quintile (>1.27 mg/L) compared with 0.21% per year or less in all other quintiles. After multivariable adjustment for known risk factors for PAD, elevated cystatin C levels remained associated with the outcome (hazard ratio, 2.5 for highest vs lowest quintile of cystatin C, 95% confidence interval, 1.2-5.1). The highest quintiles of serum creatinine level and eGFR were not associated with future PAD events in either unadjusted or adjusted analyses.</p><p><b>CONCLUSION: </b>Elevated concentrations of cystatin C were independently predictive of incident PAD events among community-dwelling elderly patients.</p>
DOI10.1001/archinte.165.22.2666
Alternate JournalArch Intern Med
PubMed ID16344426
Grant ListN01 HC 15103 / HC / NHLBI NIH HHS / United States
N01 HC 35129 / HC / NHLBI NIH HHS / United States
N01 HC 85079 / HC / NHLBI NIH HHS / United States
N01 HC 85080 / HC / NHLBI NIH HHS / United States
N01 HC 85081 / HC / NHLBI NIH HHS / United States
N01 HC 85082 / HC / NHLBI NIH HHS / United States
N01 HC 85083 / HC / NHLBI NIH HHS / United States
N01 HC 85084 / HC / NHLBI NIH HHS / United States
N01 HC 85085 / HC / NHLBI NIH HHS / United States
N01 HC 85086 / HC / NHLBI NIH HHS / United States
R01 HL 073208-01 / HL / NHLBI NIH HHS / United States