Cystatin C and risk of vascular and nonvascular mortality: a prospective cohort study of older men.
OBJECTIVE: To assess the relevance of cystatin C, as a marker of mild-to-moderate renal impairment, for vascular and nonvascular mortality in older people. DESIGN: Prospective cohort study. SETTING: Re-survey in 1997 to 1998 of survivors in the 1970 Whitehall study of London civil servants. SUBJECTS...
| Main Authors: | , , , , , , |
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| Format: | Journal article |
| Language: | English |
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2010
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| _version_ | 1797076964997070848 |
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| author | Emberson, JR Haynes, R Dasgupta, T Mafham, M Landray, M Baigent, C Clarke, R |
| author_facet | Emberson, JR Haynes, R Dasgupta, T Mafham, M Landray, M Baigent, C Clarke, R |
| author_sort | Emberson, JR |
| collection | OXFORD |
| description | OBJECTIVE: To assess the relevance of cystatin C, as a marker of mild-to-moderate renal impairment, for vascular and nonvascular mortality in older people. DESIGN: Prospective cohort study. SETTING: Re-survey in 1997 to 1998 of survivors in the 1970 Whitehall study of London civil servants. SUBJECTS: Five thousand three hundred and seventy-one men (mean age at resurvey: 77 years) who took part in the resurvey and had plasma cystatin C concentration measured. MAIN OUTCOME MEASURES: Cause-specific mortality over subsequent 11 years (1997 to 2008). METHODS: Cox regression was used to estimate the associations of cystatin C with vascular and nonvascular mortality, before and after adjustment for prior disease and other risk factors (including lifetime blood pressure). RESULTS: During an 11.0-year follow-up period, there were 1171 deaths from vascular causes [26 per 1000 per year (py)] and 1615 deaths from nonvascular causes (36 per 1000 py). Compared with men with cystatin C in the bottom fifth of the distribution, men in the top 10th had about two-fold higher mortality rates from vascular and nonvascular mortality (fully adjusted P both <0.001) even after adjustment for prior disease and all measured confounders, including lifetime blood pressure. The fully adjusted relative risks per 50% higher cystatin C concentrations were 1.66 [95% CI 1.48 to 1.85] for vascular mortality, 1.92 [95% CI 1.66 to 2.22] for ischaemic heart disease mortality and 1.46 [95% CI 1.31 to 1.61] for nonvascular mortality. CONCLUSIONS: In older men, plasma concentration of cystatin C, probably as a marker of mild renal disease, is a strong independent predictor of both vascular and nonvascular mortality. |
| first_indexed | 2024-03-07T00:10:58Z |
| format | Journal article |
| id | oxford-uuid:793658db-0f8e-4471-9e25-829aaa428c79 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T00:10:58Z |
| publishDate | 2010 |
| record_format | dspace |
| spelling | oxford-uuid:793658db-0f8e-4471-9e25-829aaa428c792022-03-26T20:35:57ZCystatin C and risk of vascular and nonvascular mortality: a prospective cohort study of older men.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:793658db-0f8e-4471-9e25-829aaa428c79EnglishSymplectic Elements at Oxford2010Emberson, JRHaynes, RDasgupta, TMafham, MLandray, MBaigent, CClarke, ROBJECTIVE: To assess the relevance of cystatin C, as a marker of mild-to-moderate renal impairment, for vascular and nonvascular mortality in older people. DESIGN: Prospective cohort study. SETTING: Re-survey in 1997 to 1998 of survivors in the 1970 Whitehall study of London civil servants. SUBJECTS: Five thousand three hundred and seventy-one men (mean age at resurvey: 77 years) who took part in the resurvey and had plasma cystatin C concentration measured. MAIN OUTCOME MEASURES: Cause-specific mortality over subsequent 11 years (1997 to 2008). METHODS: Cox regression was used to estimate the associations of cystatin C with vascular and nonvascular mortality, before and after adjustment for prior disease and other risk factors (including lifetime blood pressure). RESULTS: During an 11.0-year follow-up period, there were 1171 deaths from vascular causes [26 per 1000 per year (py)] and 1615 deaths from nonvascular causes (36 per 1000 py). Compared with men with cystatin C in the bottom fifth of the distribution, men in the top 10th had about two-fold higher mortality rates from vascular and nonvascular mortality (fully adjusted P both <0.001) even after adjustment for prior disease and all measured confounders, including lifetime blood pressure. The fully adjusted relative risks per 50% higher cystatin C concentrations were 1.66 [95% CI 1.48 to 1.85] for vascular mortality, 1.92 [95% CI 1.66 to 2.22] for ischaemic heart disease mortality and 1.46 [95% CI 1.31 to 1.61] for nonvascular mortality. CONCLUSIONS: In older men, plasma concentration of cystatin C, probably as a marker of mild renal disease, is a strong independent predictor of both vascular and nonvascular mortality. |
| spellingShingle | Emberson, JR Haynes, R Dasgupta, T Mafham, M Landray, M Baigent, C Clarke, R Cystatin C and risk of vascular and nonvascular mortality: a prospective cohort study of older men. |
| title | Cystatin C and risk of vascular and nonvascular mortality: a prospective cohort study of older men. |
| title_full | Cystatin C and risk of vascular and nonvascular mortality: a prospective cohort study of older men. |
| title_fullStr | Cystatin C and risk of vascular and nonvascular mortality: a prospective cohort study of older men. |
| title_full_unstemmed | Cystatin C and risk of vascular and nonvascular mortality: a prospective cohort study of older men. |
| title_short | Cystatin C and risk of vascular and nonvascular mortality: a prospective cohort study of older men. |
| title_sort | cystatin c and risk of vascular and nonvascular mortality a prospective cohort study of older men |
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