HMN 2026: How Cystatin C is tied to worse heart failure outcomes across ejection fraction spectrum

Cystatin C (CysC) is an independent risk factor for adverse outcomes in patients with heart failure (HF) across the ejection fraction (EF) spectrum, according to a study published in Clinical Cardiology.

Lyu Lyu, from the Capital Medical University in Beijing, and colleagues investigated the relationship between CysC and adverse outcomes in HF patients across the whole EF spectrum. The analysis included 637 HF patients with normal-to-mild renal insufficiency.

The researchers found that overall, there were significant associations between elevated CysC levels and increased risks for all-cause mortality and HF rehospitalization over 9.4 years of follow-up. The risk for all-cause mortality was higher for patients with midrange EF and reduced EF versus patients with preserved EF. CysC had less prognostic impact on all-cause mortality in patients with preserved EF.

The addition of CysC to the MAGGIC risk score-based model had additional prognostic value for all patients, even with N-terminal pro-brain natriuretic peptide levels added.

“This research is the first to demonstrate a significant correlation between CysC levels and long-term outcomes across all hospitalized HF patient types with normal-to-mild renal dysfunction, backed by an extensive follow-up period,” the authors write.

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