Serum cystatin C is a potential predictor of short-term mortality and acute kidney injury in acute aortic dissection patients: a retrospective cohort study
Jun Wang, Biwen Yang, Meili Liu, Tao You, Shen Han, Yihuan Chen, Haoyue Huang, Shifeng Li, Zhiyang Wang, Xinyue Li, Fang Huang, Xiao-Mei Teng
Abstract
Background: Serum cystatin C concentration is associated with cardiovascular disease. However, the relationship between cystatin C and acute aortic dissection (AAD) remains unclear. In the current study, we aim to evaluate the predictive value of cystatin C in the occurrence of acute kidney injury (AKI) and the prognosis of AAD patients. Methods: The patients with AAD admitted to our hospital from November 2019 through January 2022 were consecutively included in the retrospective cohort study. A complete blood cell count, serum biochemistry tests, including cystatin C and creatinine, in-hospital mortality and the incidence of AKI were recorded. All the patients were categorized into four groups according to the quartile of their serum cystatin C levels. Multivariate logistic and Cox regression analyses were conducted to determine the independent risk factors for the incidence of AKI and the prognosis of AAD patients, respectively. Kaplan-Meier analyses and log-rank tests were used to evaluate differences in survival. Receiver operating characteristic (ROC) curves were used to assess the predictive value of cystatin C for short-term mortality and the incidence of AKI in AAD patients. Results: /L, and serum cystatin C concentration >1.18 mg/L [adjusted hazards ratio (HR) =2.405, 95% confidence interval (CI), 1.029-4.063, P=0.041] were independent risk factors for in-hospital mortality. Cystatin C levels >1.18 mg/L remained an independent predictor of AKI in AAD after adjusting for the confounding [odds ratio (OR) 76.489, 95% CI, 25.586-228.660]. The areas under the ROC curves of cystatin C in predicting the mortality and incidence of AKI in AAD patients were 0.655 (95% CI, 0.551-0.760) and 0.807 (95% CI, 0.758-0.856), respectively. Conclusions: In sum, serum cystatin C concentration is a potential predictor of short-term mortality and the incidence of AKI in AAD patients.