Prediction efficiency of serum cystatin C for clinical outcome in patients with cardiac resynchronization therapy

Since only 60–70% of select patients with chronic heart failure (CHF) are responders in cardiac resynchronization therapy (CRT), this study aimed to investigate whether serum cystatin C (Cys C) can be used to evaluate the effectiveness of CRT in patients with CHF.

Seventy-six patients implanted with CRT were retrospectively enrolled. The concentration of serum Cys C was detected and echocardiography was performed before and after 15 days, 1 month, and 6 months of CRT.

There were 52 patients (68.4%) who responded to CRT during the follow-up. In the responding group, compared with the pre-CRT, the cardiac function, QRS interval, left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), and left ventricular ejection fraction (LVEF) were significantly improved at 6 months after implantation (P < 0.05), but the level of serum Cys C decreased significantly from 1 month after CRT. There was no change of all the parameters in the non-responding group during the follow-up. In the responding group, the ΔCys C% is significantly related to the ΔLVEDV%, ΔLVESV%, and ΔLVEF%. Multivariate linear analysis shows that the ΔCys C% is significantly related to the ΔLVEDV%. The level of serum Cys C before CRT implantation could predict the response to CRT (AUC = 0.78, P < 0.05). Univariate analysis and multivariate analysis demonstrated that the level of Cys C remained independent predictor for CRT (P = 0.028, 95% CI 0.919–1.348).

The level of serum Cys C before CRT implantation is valuable in predicting the response to CRT.