Comparison of Cardiovascular Prognosis by 3 Serum Cystatin C Methods in the Heart and Soul Study

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Shlipak, Michael G. (författare)

Comparison of Cardiovascular Prognosis by 3 Serum Cystatin C Methods in the Heart and Soul Study

Artikel/kapitelEngelska2011

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2011-05-01
Oxford University Press (OUP),2011
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LIBRIS-ID:oai:DiVA.org:uu-149738
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-149738URI
https://doi.org/10.1373/clinchem.2010.158915DOI

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Språk:engelska
Sammanfattning på:engelska

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BACKGROUND: Cystatin C is a promising new biomarker to estimate glomerular filtration (eGFR). However, the Siemens' cystatin C assay (Siemens), used in many longitudinal studies, has had limited clinical applicability because it requires a specific, dedicated instrument. Other companies, including Gentian and Roche, have developed cystatin C assays that can be used with most routine clinical chemistry analyzers. METHODS: We compared the agreement of Gentian and Roche with Siemens in 948 participants at the baseline visit of the Heart and Soul Study, a cohort of participants with established coronary artery disease who were followed for an average of 8 years. We then compared associations of all 3 cystatin C measures and eGFR-Modification of Diet in Renal Disease (MDRD) with clinical outcomes. RESULTS: The Gentian assay had higher correlation with Siemens (r = 0.96) than did Roche (r = 0.93, P < 0.001). After cross-tabulating quartiles of each cystatin C measure, agreements (κ statistic) were higher for Siemens and Gentian (0.73, 95% CI 0.72-0.75) than for Roche and Siemens (0.64, 0.63-0.66) or for Roche and Gentian (0.69, 0.65-0.71). These differences in agreement had minimal impact on associations with clinical outcomes; the hazard ratios (HRs) for mortality comparing the high vs low quartiles were 3.2 (95% CI 2.1-4.8) for Siemens, 3.1 (CI 2.1-4.7) for Gentian, 3.1 (CI 2.1-4.7) for Roche, and 1.6 (CI 1.1-2.3) for eGFR-MDRD, after multivariate adjustment. CONCLUSIONS: In summary, agreement with the Siemens' assay was modestly higher for the Gentian compared with the Roche assay, although all 3 methods for cystatin C measurement had similar utility as predictors of clinical outcomes.

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MEDICINE
MEDICIN

Biuppslag (personer, institutioner, konferenser, titlar ...)

Weekley, Cristin C. (författare)
Li, Yongmei (författare)
Hansson, Lars-OlofUppsala universitet,Klinisk kemi,biologisk struktur och funktion (författare)
Larsson, AndersUppsala universitet,Klinisk kemi,biologisk struktur och funktion(Swepub:uu)andla606 (författare)
Whooley, Mary (författare)
Uppsala universitetKlinisk kemi (creator_code:org_t)

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Ingår i:Clinical Chemistry: Oxford University Press (OUP)57:5, s. 737-7450009-91471530-8561

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Av författaren/redakt...: Shlipak, Michael ...; Weekley, Cristin ...; Li, Yongmei; Hansson, Lars-Ol ...; Larsson, Anders; Whooley, Mary

Artiklar i publikationen: Clinical Chemist ...

Av lärosätet: Uppsala universitet

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