The Clinical Application Of Serum Cystatin C In Patients With Chronic Heart Failure

Research Background: Cystatin C was found in recent years as an idealmarker for the evaluation of renal function and was more sensitive to the minorchanges of glomerular filtration rate than serum creatinine and blood ureanitrogen. The studies abroad show that as an independent risk factor forpatients with chronic heart failure, the concentration of Cystatin C was a bettermeasurement than Serum Creatinine in prognosis evaluation. However fewerstudies in this field were found in our country. In this essay, through detectingthe level of Cystatin C in patients with congestive heart failure, the authordiscussed the laboratory diagnostic means of the early kidney injury forpatients with CHF and the influence of heart functions on renal function;analyzed the relationship of level of Cystatin C and prognosis of patients(within3months); and further clarified the clinical application of Cystatin C inpatients with CHF.Research Methodology: The study selected patients with congestive heartfailure treated in our hospital between June,2011and November,2011asresearch objects. According to the inclusion and exclusion criteria,62caseswere selected, including21cases of ischemic cardiomyopathy,14cases ofvalvular disease,13cases of dilated cardiomyopathy and14cases ofhypertensive heart disease. According to NYHA classification of heart function,these patients can be divided into19cases of NYHAⅡ,19cases of NYHA Ⅲand24cases of NYHA Ⅳ. There are34male patients and28female patientsaged48-85with an average age of61.95±12.92. While62cases coming to ourhospital for health checkup during the same period were selected as controlgroup. The records of patients include sex, age, height, body weight, systolic and diastolic blood pressure, the first Cystatin C value of patients within24hours, blood urea nitrogen (BUN), brain natriuretic peptide (BNP), leftventricular ejection fraction(LVEF). The values of Cystatin C were comparedbetween heart failure group and control group, and between patients withdifferent cardiac function grading. And the major cardiovascular events,mortality and readmission rates were recorded about the patients during’hospitalization or being discharged within3months by telephone follow-upand queries. All the research data were analyzed through statistical softwareSPSS17.0.Research Results: Compared with the control group,blood levels ofBNP， CvsC both elevated，left ventricular ejection fraction (LVEF) decreased(P<O．05or P<0．01)in CHF group. Blood levels of BNP and CysC elevatedsignificantly and LVEF lowered significantly in CHF patients with NYHAfunctional classesⅡ， Ⅲ and Ⅳt han those in control group．There wassignificant difference in blood Levels of BNP and CvsC between patients withvaried NYHA functional classes(P<0.05)．Blood level of CysC correlated withthat of BNP(r=4.375E-5,P<0.01),Blood levels of BNP and CysC reverselycorrelated with LVEF（r=-0.042,P<0.01）．Compared with normal cystatin C(CysC) group (CysC <1.5mg/L), the high cystatin C (CysC) grouppatients are higher in the incidence of cardiovascular events, the all-cause ratewithin3months, the readmission rates within3months. As for the cystatin C(CysC) level of different patients: The cystatin C (CysC) level of the diedpatients is (2.52±0.84mg/L), being higher than the recovered patients(1.68±0.76mg/L). The differences between the two are statistically significant(P <0.05). For patients with congestive heart failure caused bycardiomyopathy, valvular heart disease, hypertension, dilated cardiomyopathy,the different levels of cystatin C (CysC) are non-statistically significant.Research conclusions: For patients with congestive heart failure and impaired renal function, cystatin C can quickly and accurately reflect thepatients’ early impaired renal function, evaluate the level of heart failure, andhas important clinical implications on the judgment of the prognosis of patients.Compared with blood Scr and urea nitrogen, cystatin C, being more sensitiveand accurate, is an ideal endogenous marker for patients with congestive heartfailure. In clinical practice, the detection of serum cystatin C (CysC) levelshas certain values on guiding treatment.