Abstract 13357: Cystatin C Based Estimated Glomerular Filtration Rate (eGFR) Predicts Adverse Clinical Outcomes More Effectively Than Creatinine Based eGFR in Patients With Peripheral Artery Disease

• Published in: Circulation (New York, N.Y.) N.Y.), 2015-11, Vol.132 (Suppl_3 Suppl 3), p.A13357-A13357
• Main Authors: Yoichiro, Otaki, Watanabe, Tetsu, Takahashi, Hiroki, Yamaura, Gensai, Arimoto, Takanori, Shishido, Tetsuro, Miyamoto, Takuya, Kubota, Isao
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.132.suppl_3.13357

IntroductionKidney dysfunction is reported to be associated with adverse outcome in patients with peripheral artery disease (PAD). Estimated glomerular filtration rate (eGFR), which is recently-popularized index for assessing kidney function, is calculated using serum creatinine or cystatin C level. Cystatin C based eGFR (eGFRcys) is less affected by age, gender, and muscle mass compared to creatinine based eGFR (eGFRcr).HypothesisWe hypothesized that eGFRcys is a feasible prognostic parameter despite muscle sarcopenia in patients with PAD.MethodsWe calculated both eGFRcr and eGFRcys according to kidney disease improving global outcomes (KDIGO) guideline in 235 PAD patients who underwent endovascular therapy. Patients were prospectively followed during a median follow up period of 618 days, with the end points of major adverse cardiovascular and cerebrovascular events (MACCE).ResultsA multivariate Cox proportional hazard analysis revealed that eGFRcys, but not eGFRcr, was an independent predictor of MACCE. The C index was larger for eGFRcys than eGFRcr (0.70 versus 0.61; P=0.0071). Kaplan-Meier analysis demonstrated that incidence of MACCE was increased with advancing chronic kidney disease stage based on eGFRcys, but not eGFRcr, in patients with PAD. Net reclassification index was improved by addition of eGFRcys to basic predictors.ConclusionseGFRcys could be a reliable marker for MACCE and risk stratify patients at high risk more effectively than eGFRcr in patients with PAD.