Impact of Contrast-Induced Nephropathy and Cardiovascular Events by Serum Cystatin C in Renal Insufficiency Patients Undergoing Cardiac Catheterization

We assessed the usefulness of serum cystatin C for predicting contrast-induced nephropathy (CIN) in patients (n = 100) undergoing coronary catheterization. After a 12-month follow-up, the incidence of CIN was 8.3% (n = 5) in patients with mild renal insufficiency (estimated glomerular filtration rate [eGFR] 60-89 mL/min per 1.73 m(2)), 34.4% (n = 10) in those with moderate renal insufficiency (eGFR 30-59 mL/min per 1.73 m(2)), and 100% (n = 3) in those with severe renal insufficiency (eGFR 15-29 mL/min per 1.73 m(2)). The sensitivity was 81.8% and specificity was 90.9% at the cutoff level of serum cystatin C > 1.18 mg/L. Serum cystatin C levels were significantly (P < .001) higher in the patients with moderate renal insufficiency in the CIN group than those in the non-CIN group. Multivariate logistic regression analysis demonstrated that baseline serum cystatin C independently predicted short-term mortality (odds ratio [OR], 0.311; 95% confidence interval [CI] 0.058-0.538; P = .026). Baseline serum cystatin C significantly predicted the occurrence of CIN in the patients with moderate renal insufficiency.