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The DOI matches its Crossref record; 4 of the 4 references it cites were found in a registry or an index.

Cystatin C and the Risk of Death and Cardiovascular Events among Elderly Persons

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Shlipak, Michael G., Sarnak, Mark J., Katz, Ronit, Fried, Linda F., Seliger, Stephen L., Newman, Anne B., Siscovick, David S., Stehman-Breen, Catherine·2005·New England Journal of Medicine
DOI 10.1056/nejmoa043161
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Abstract

BACKGROUND: Cystatin C is a serum measure of renal function that appears to be independent of age, sex, and lean muscle mass. We compared creatinine and cystatin C levels as predictors of mortality from cardiovascular causes and from all causes in the Cardiovascular Health Study, a cohort study of elderly persons living in the community. METHODS: Creatinine and cystatin C were measured in serum samples collected from 4637 participants at the study visit in 1992 or 1993; follow-up continued until June 30, 2001. For each measure, the study population was divided into quintiles, with the fifth quintile subdivided into thirds (designated 5a, 5b, and 5c). RESULTS: Higher cystatin C levels were directly associated, in a dose-response manner, with a higher risk of death from all causes. As compared with the first quintile, the hazard ratios (and 95 percent confidence intervals) for death were as follows: second quintile, 1.08 (0.86 to 1.35); third quintile, 1.23 (1.00 to 1.53); fourth quintile, 1.34 (1.09 to 1.66); quintile 5a, 1.77 (1.34 to 2.26); 5b, 2.18 (1.72 to 2.78); and 5c, 2.58 (2.03 to 3.27). In contrast, the association of creatinine categories with mortality from all causes appeared to be J-shaped. As compared with the two lowest quintiles combined (cystatin C level, < or =0.99 mg per liter), the highest quintile of cystatin C (> or =1.29 mg per liter) was associated with a significantly elevated risk of death from cardiovascular causes (hazard ratio, 2.27 [1.73 to 2.97]), myocardial infarction (hazard ratio, 1.48 [1.08 to 2.02]), and stroke (hazard ratio, 1.47 [ 1.09 to 1.96]) after multivariate adjustment. The fifth quintile of creatinine, as compared with the first quintile, was not independently associated with any of these three outcomes. CONCLUSIONS: Cystatin C, a serum measure of renal function, is a stronger predictor of the risk of death and cardiovascular events in elderly persons than is creatinine.

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Metadata

Authors
Shlipak, M. G., Sarnak, M. J., Katz, R., Fried, L. F., Seliger, S. L., Newman, A. B., Siscovick, D. S., & Stehman-Breen, C.
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
2005-05-19
Volume
352
Issue
20
Pages
2049-2060
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejmoa043161
OpenAlex
W2049382000
Cited by
1,249
References
4
FWCI
42.95
Type
journal article
Language
en
Open access
bronze

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