Cystatin C, N-terminal probrain natriuretic peptides and outcomes in acute heart failure with acute kidney injury in a 12-month follow-up: Insights into the cardiorenal syndrome

Background: cystatin c (cys c) has been implicated as a prognostic marker in cardiovascular disease. the aim of this study was to evaluate the value of cys c as a marker of acute kidney injury (aki) in acute heart failure (ahf), the impact of cys c and n-terminal probrain natriuretic peptides (nt-probnp) on in-hospital and 12 months mortality were also investigated. materials and methods: a total of 162 patients with ahf were enrolled. nt-probnp, cys c, serum creatinine (scr), blood urea nitrogen (bun) and parameters of echocardiography were measured for analyze. the in-hospital and 12 months mortality was analyzed. results: there was 28 (17%) of all ahf patients with aki. compared with no-aki patients, the levels of cys c (1.51 ± 0.34 vs. 1.32 ± 0.29, p = 0.003) and nt-probnp (8163.87 ± 898.06 vs. 5922.45 ± 576.73, p = 0.001) were higher in aki patients. higher levels of nt-probnp (odds ratio (or) = 1.92, 95% confidence interval (ci): 2.19-10.98, p = 0.018, or = 4.31, 95% ci: 2.35-9.82, p = 0.002, respectively) and cys c (or = 1.48, 95% ci: 1.75-4.16, p = 0.027, or = 2.72, 95% ci: 1.92-4.28, p = 0.017, respectively) were independent association with the in-hospital and 12 months mortality. cys c was positively correlated with nt-probnp (r = 0.87, p < 0.001). combining tertiles of cys c and nt-probnp improved risk stratification further. compared with patients without akicysc, patients with akicysc was associated with higher in-hospital (7/28 vs. 10/134, p = 0.002) and 12-month mortality (13/28 vs. 32/134, p = 0.001). conclusion: cys c was not only a promising risk marker in patients hospitalized for ahf, but also an independent predictor of 12-month mortality. combining tertiles of cys c and nt-probnp could be used to distinguish the mortality risk identification of patients with ahf. aki was an independent predictor of in-hospital and 12-month mortality.