MedStar Authors catalog › Details for: Effect of cystatin C levels on angiographic atherosclerosis progression and events among postmenopausal women with angiographically decompensated coronary artery disease (from the Women's Angiographic Vitamin and Estrogen [WAVE] study).
Effect of cystatin C levels on angiographic atherosclerosis progression and events among postmenopausal women with angiographically decompensated coronary artery disease (from the Women's Angiographic Vitamin and Estrogen [WAVE] study). Journal: The American journal of cardiology. ISSN: 0002-9149. UI/PMID: 23499273. Subject(s): Age Factors | Aged | *Atherosclerosis/bl [Blood] | Atherosclerosis/et [Etiology] | Biological Markers/bl [Blood] | Canada | *Coronary Angiography | *Coronary Artery Disease/bl [Blood] | Coronary Artery Disease/dt [Drug Therapy] | Coronary Artery Disease/et [Etiology] | Coronary Artery Disease/mo [Mortality] | *Coronary Artery Disease/ra [Radiography] | *Cystatin C/bl [Blood] | Disease Progression | Double-Blind Method | Estrogen Replacement Therapy/mt [Methods] | Female | Follow-Up Studies | Glomerular Filtration Rate | Humans | *Kidney Failure, Chronic/bl [Blood] | Kidney Failure, Chronic/co [Complications] | Middle Aged | *Postmenopause | Predictive Value of Tests | Risk Factors | Sensitivity and Specificity | Treatment Outcome | United States Institution(s): MedStar Washington Hospital Center | MedStar Health Research Institute | MedStar Heart & Vascular Institute Department(s): Medicine/Gastroenterology Activity type: Journal Article. Medline article type(s): Comparative Study | Journal Article | Multicenter Study | Randomized Controlled Trial Online resources: Click here to access online Digital Object Identifier: http://dx.doi.org/10.1016/j.amjcard.2013.02.019 (Click here) Abbreviated citation: Am J Cardiol. 111(12):1681-7, 2013 Jun 15. Local Holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006.
Abstract: End-stage renal disease and mild renal insufficiency are associated with increased cardiovascular risk. Cystatin C, a novel marker of kidney function, was found to be associated with a higher frequency of cardiovascular events and mortality independent of glomerular filtration rate. It remained uncertain, however, whether enhanced cardiovascular risk associated with cystatin C is due to accelerated progression of atherosclerosis or to plaque instability. The aim of this study was to examine the effects of baseline cystatin C on annual 131223 in coronary artery narrowing and clinical events in 423 postmenopausal women with angiographically documented coronary artery disease enrolled in the Women's Angiographic Vitamin and Estrogen (WAVE) trial. Baseline and follow-up (mean 2.8 +/- 0.9 years) angiography was performed in 320 women. Angiographic progression of disease and clinical events in each cystatin C quartile were compared. Women with cystatin C levels in the highest quartile were older and more likely to have histories of heart failure and stroke. Annualized 131223s in minimal and average luminal diameters were similar in diseased and nondiseased segments. All-cause death or myocardial infarction (3.6% vs 15.6%, p <0.001), cardiovascular death or myocardial infarction (2.3% vs 13.5%, p <0.001), and cardiovascular events (3.6% vs 13.5%, p <0.001) were significantly higher in women with baseline cystatin C levels in the highest quartile compared with women with cystatin C levels in the lower 3 quartiles. The risk for clinical events associated with cystatin C remained significantly higher in multivariate logistic regression analysis after adjusting for baseline differences and cardiovascular risk factors. The risk for clinical events was also independent of estimated glomerular filtration rate. In conclusion, in postmenopausal women with angiographically documented coronary artery disease, baseline cystatin C levels were associated with worse clinical outcomes without accelerated progression of atherosclerosis. Copyright 2013 Elsevier Inc. All rights reserved.