Can plasma cystatin c predict clinical outcomes in hospitalized patients with acute decompensated heart failure?

Background: Acute decompensated heart failure (ADHF) is an important cause of hospital admissions, morbidity and mortality. Objectives: To evaluate role of plasma cystatin C in prediction of adverse in-hospital clinical outcome in patients with ADHF. Methods and results: Among 90 patients hospitalized with ADHF, clinical examination and echocardiographic assessment were done. Renal functions including serum urea, creatinine and estimated glomerular filtration rate (eGFR) were followed up daily. Plasma cystatin C was measured on admission and at 24 and 72 hours. The composite in-hospital adverse clinical outcome included the composite of death, need for ultrafiltration for refractory edema and hypotension requiring vasopressors. Mean value of plasma cystatin C on admission was 1822.7±553 mg/l. Independent predictors of the composite adverse in-hospital clinical outcome were left ventricular end-systolic diameter and admission values of plasma cystatin C. Admission plasma cystatin C ≥ 1707.5 mg/l had 80% sensitivity and 72% specificity for the prediction of the composite adverse in-hospital clinical outcome. Conclusions: Among patients hospitalized with ADHF, measurement of plasma cystatin C on admission can identify patients at increased risk for developing in-hospital adverse clinical outcomes.