Work

Serum cystatin-C and all-cause mortality in patients with hypertrophic cardiomyopathy: a retrospective cohort study

Year: 2025

Type: article

Abstract: Background Numerous studies across various populations have revealed that elevated cystatin-C levels are associated with an excessive risk of mortality. However, the prognostic value of cystatin-C remains unidentified in hypertrophic cardiomyopathy (HCM) patients. The objective of this study was to investigate whether serum cystatin-C could predict all-cause mortality independently in HCM patients. Methods Data from 456 HCM patients treated at West China Hospital were collected and stratified into two groups based on the median baseline serum cystatin-C level. All-cause mortality was the primary outcome. Cox regression models were used to analyze the association between cystatin-C levels and mortality risk. Results A total of 90 deaths were recorded over a median follow-up period of 4.67 years. Patients with higher cystatin-C levels had an increased risk of all-cause mortality (adjusted hazard ratio (HR): 2.11, 95% CI [1.30–3.42], p = 0.003) compared to those with lower levels. Time-dependent area under the curves (AUC) of cystatin-C in different time points, ranging from initial measurement to follow-up, showed a relatively stable fluctuation between 0.70 and 0.80. In comparison, the commonly used renal function markers, estimated glomerular filtration rate (eGFR) and serum creatinine, yielded lower AUC values. Restricted cubic spline curves showed that with median value of cystatin-C (1.01 mg/L) as reference, there was a gradual rise in risk of all-cause mortality with cystatin-C increasing. Subgroup analyses in female, in the patients ≥ 58 years old, and in the patients with eGFR ≥ 60 mL/min/1.73 m 2 consistently confirmed robustness of the main findings. Conclusion Elevated serum cystatin-C levels are associated with a higher risk of all-cause mortality in HCM patients, providing valuable prognostic information beyond traditional renal function markers such as eGFR and serum creatinine.

Source: PeerJ

DOI: 10.7717/peerj.19631

Authors: Lu Liu, Yi Zheng, Haiyan Ruan, Ziqiong Wang, Xiaoping Chen, Sen He

Institution: West China Hospital of Sichuan University

Language: English

Topic: Cardiomyopathy and Myosin Studies

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,395