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Cystatin C predicts CV events.

Serum level of cystatin C, which measures renal function, was a stronger predictor of cardiovascular events and of mortality in a study of elderly subjects than were creatinine level and estimated glomerular filtration rate, according to Michael G. Shlipak, M.D., of the University of California, San Francisco, and his associates.

In 4,637 ambulatory elderly subjects followed for a mean of 7 years, cystatin C was the best predictor of CV events, cardiac mortality, and overall mortality. They were able to define low-risk levels (<1.00 mg/L), intermediate-risk levels (1.00-1.28 mg/L), and high-risk levels (1.29 mg/L or more) of cystatin C, the researchers said (N. Engl. J. Med. 2005;352:2049-60).

In an editorial, Lesley A. Stevens, M.D., and Andrew S. Levey, M.D., both of Tufts-New England Medical Center, Boston, said these results suggest that the higher risk of CVD among elderly patients with kidney disease "may be stronger and occur at higher levels of [glomerular filtration rate] than previously suspected."

All elderly patients should be evaluated for possible kidney disease, and those found to have it "should be considered to be in the highest risk group for [cardiovascular] disease and should receive intensive risk-reduction therapy," they said (N. Engl. J. Med. 2005;352:2122-4).
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Title Annotation:CLINICAL CAPSULES
Author:Moon, Mary Ann
Publication:Internal Medicine News
Article Type:Brief Article
Geographic Code:1USA
Date:Jul 15, 2005
Words:214
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