Frontiers in Neurology (Aug 2021)
Serum Cystatin C Predicts Stroke Clinical Outcomes at 1 Year Independent of Renal Function
- Yarong Ding,
- Yarong Ding,
- Yarong Ding,
- Yarong Ding,
- Liping Liu,
- Liping Liu,
- Liping Liu,
- Liping Liu,
- Zimo Chen,
- Zimo Chen,
- Zimo Chen,
- Zimo Chen,
- Hao Li,
- Hao Li,
- Hao Li,
- Hao Li,
- Yuesong Pan,
- Yuesong Pan,
- Yuesong Pan,
- Yuesong Pan,
- Junfeng Wang,
- Xia Meng,
- Xia Meng,
- Xia Meng,
- Xia Meng,
- Jinxi Lin,
- Jinxi Lin,
- Jinxi Lin,
- Jinxi Lin,
- Jing Jing,
- Jing Jing,
- Jing Jing,
- Jing Jing,
- Xuewei Xie,
- Xuewei Xie,
- Xuewei Xie,
- Xuewei Xie,
- Xianglong Xiang,
- Xianglong Xiang,
- Xianglong Xiang,
- Xianglong Xiang,
- Yongjun Wang,
- Yongjun Wang,
- Yongjun Wang,
- Yongjun Wang
Affiliations
- Yarong Ding
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Yarong Ding
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Yarong Ding
- Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China
- Yarong Ding
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
- Liping Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Liping Liu
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Liping Liu
- Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China
- Liping Liu
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
- Zimo Chen
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Zimo Chen
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Zimo Chen
- Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China
- Zimo Chen
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
- Hao Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Hao Li
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Hao Li
- Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China
- Hao Li
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
- Yuesong Pan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Yuesong Pan
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Yuesong Pan
- Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China
- Yuesong Pan
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
- Junfeng Wang
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
- Xia Meng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Xia Meng
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Xia Meng
- Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China
- Xia Meng
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
- Jinxi Lin
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Jinxi Lin
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Jinxi Lin
- Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China
- Jinxi Lin
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
- Jing Jing
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Jing Jing
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Jing Jing
- Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China
- Jing Jing
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
- Xuewei Xie
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Xuewei Xie
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Xuewei Xie
- Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China
- Xuewei Xie
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
- Xianglong Xiang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Xianglong Xiang
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Xianglong Xiang
- Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China
- Xianglong Xiang
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
- Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Yongjun Wang
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Yongjun Wang
- Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China
- Yongjun Wang
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
- DOI
- https://doi.org/10.3389/fneur.2021.676872
- Journal volume & issue
-
Vol. 12
Abstract
Objective: Serum cystatin C (CysC) is a sensitive marker of renal function to predict cardiovascular diseases. We aimed to investigate the predictive value of CysC for clinical outcomes independent of renal function in patients with acute ischemic stroke (AIS).Methods: We measured serum CysC levels in 10,256 AIS patients from Third China National Stroke Registry (CNSR-III). The primary outcome was a combination of all-cause mortality and major disability (modified Rankin scale score, 3–6). Secondary outcomes included stroke recurrence and combined vascular events at 1 year. Outcomes were analyzed using logistic regression and Cox proportional hazards models, respectively.Results: The median CysC of included patients was 0.95 mg/l (interquartile range, 0.83–1.10 mg/l). A U-shaped association was observed between CysC and primary outcome (all-cause mortality or major disability) [quartile (Q)1 vs. Q2: adjusted odds ratio (aOR) 1.29, 95% CI 1.06–1.58, p = 0.012; Q3 vs. Q2: aOR 1.12, 95% CI 0.93–1.35, p = 0.242; Q4 vs. Q2: aOR 1.35, 95% CI 1.10–1.65, p = 0.004]. A similar trend also existed in “preserved renal function” patients. Adding CysC to a model containing conventional risk factors improved the model performance with integrated discrimination improvement (IDI) of 0.13% (p = 0.016) and net reclassification index (NRI) of 13.10% (p <0.001) for primary outcome. No significant association was observed for stroke recurrence or combined vascular event rate in different CysC quartiles.Conclusions: CysC showed a U-shaped correlation with 1-year stroke clinical outcome, suggesting that serum CysC may not only be a simple candidate marker of renal function.
Keywords