Luiz Sérgio F. de Carvalho et al. Thiago Quinaglia AC Silva Otávio Rizzi Coelho-Filho
While the development of novel risk factors for cardiovascular risk assessment is necessary to improve risk stratification, proving its clinical value on top of traditional risk factors is routinely challenging.– Besides all the innovative and straightforward biomarker research published in the last decades, only very few markers of cardiovascular risk have shown clinical significance., Among many of them, cystatin C has emerged some years ago as a candidate for improving cardiovascular risk stratification.
In the Cardiovascular Health Study (CHS), a community-based and longitudinal study with over 4,600 elderly individuals, cystatin C has shown to predict cardiovascular outcomes. As compared with the lowest quintile, the highest quintile of cystatin C was associated with a significantly increased risk of death from cardiovascular causes (hazard ratio [HR] 2.27 [1.73 to 2.97]), myocardial infarction (HR 1.48 [1.08 to 2.02]), and stroke (HR 1.47 [1.09 to 1.96]) after multivariate adjustment. However, cystatin C is typically known as a marker of renal function, being roughly correlated with glomerular filtration rate in early stages of kidney diseases., Reasonably, since glomerular function is a strong surrogate marker of cardiovascular disease, it suggests an obvious association between cystatin C and cardiovascular outcomes. A mechanism to avoid the impact of this inexorable bias was to study only individuals with normal kidney function. Yet, additional studies have shown inconsistent magnitudes of effect between cystatin C and cardiovascular outcomes.
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