#909 Role of cystatin C in the development and progression of chronic heart failure in patients with diabetes

Abstract Background and Aims It has been known that cystatin C is a marker for early prediction of renal function. In recent years, studies have shown that cystatin C plays an important role in predicting new or worsening cardiovascular diseases. The aim of our study was to investigate the role of cystatin C in the development and progression of chronic heart failure (CHF) in patients with diabetes. Method A total of 499 patients with DT1 and DT2, aged 34 to 84 years (60 [60; 72]), were examined. All patients underwent standard clinical and laboratory examination, with an assessment of the levels of the natriuretic peptides (BNP and NTproBNP) in baseline plasma samples. Renal function was assessed based on the levels of serum creatinine and cystatin C. Patients were divided into quartiles according to cystatin C levels: Q1 <0.78 mg/l, Q2 0.78-0.92 mg/l, Q3 0.93-1.38 mg/l, Q4 >1.38 mg/l. Results Significant differences in the levels of BNP and NTproBNP were observed in patients with diabetes with cystine C levels ≥0.93 mg/l (32.20 [19.85; 69.35] pg/ml and 104.25 [57.70; 210.08] ng/l, respectively). There were significant correlations between cystatin C and the levels of BNP (r = 0.56, p < 0.05) and NTproBNP (r = 0.58, p < 0.05). Logistic regression analysis showed the prognostic value of cystatin C, and not creatinine, as a predictor of heart failure in patients with diabetes and GFR>60 ml/min/1.73 m2 (1 mg/l increase of cystatin C was associated with 7.085 times increase in CHF odds). ROC analysis revealed that the level of cystatin C ≥0.96 mg/l with a sensitivity of 84% and specificity of 75% predicted increased BNP and NTproBNP in patients with diabetes (ROC AUC = 0.844). Conclusion Cystatin C level could be used as a predictive indicator of CHF in patients with diabetes and GFR>60 ml/min/1.73 m2.