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(Stroke. 2007;38:3287.)
© 2007 American Heart Association, Inc.

Research Letters

Cystatin C, Associated With Hemorrhagic and Ischemic Stroke, Is a Strong Predictor of the Risk of Cardiovascular Events and Death in Chinese

Li Ni, MD; Jiagao Lü, MD; Ling Bo Hou, MD; Jiang Tao Yan, MD; Qiao Fan, BSMT; Rutai Hui, MD, PhD; Katherine Cianflone, PhD; Wei Wang, MD, PhD Dao Wen Wang, MD, PhD

From the Institute of Hypertension and Departments of Internal Medicine (L.N., J.L., L.B.H., J.T.Y., Q.F., D.W.W.) and Neurology (W.W.), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Fuwai Hospital (R.H.), Peking Union Medical College, Beijing, China; and Centre de Recherche Hôpital Laval (K.C.), Laval University, Quebec, Canada.

Correspondence to Dao Wen Wang and Wei Wang, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China. E-mail dwwang{at}tjh.tjmu.edu.cn

Abstract

Background and Purpose— Cystatin C, a serum measure of renal function, has been reported as a strong predictor of risk of death and cardiovascular events in elderly people. We investigated the association between cystatin C and first-ever stroke and evaluated the predictive value of cysctatin C in cardiovascular events and death from all causes based on the outcomes of a 5-year follow-up.

Methods— We recruited 293 stroke patients (199 cases of cerebral infarction, 94 cases of cerebral hemorrhage) and 894 controls. For each measure, the study population was divided into quintiles.

Results— Total plasma cystatin C levels were significantly higher in patients than controls. Higher cystatin C levels were directly associated with a higher risk of stroke. As compared with the first (lowest) quintile, the hazard ratios (and 95% CIs) for stroke were as follows: second quintile, 1.97 (1.07 to 3.64); third quintile, 2.71 (1.50 to 4.90); fourth quintile, 3.79 (2.12 to 6.75); fifth quintile, 6.38 (3.60 to 11.32). Follow-up of the patients and controls also showed that high cystatin C levels were associated with high prevalence of cardiovascular events or death from all causes.

Conclusions— Elevated cystatin C levels were independently associated with both ischemic and hemorrhagic stroke, and cystatin C was a strong predictor for the risk of cardiovascular events and death.

Key Words: cerebral hemodynamics • cerebral infarct • cerebrovascular disease • clinical neurology • cystatin C • prognosis • risk factors • stroke