JACC: Heart Failure
Clinical Research
Comparative Assessment of Short-Term Adverse Events in Acute Heart Failure With Cystatin C and Other Estimates of Renal FunctionResults From the ASCEND-HF Trial
W.H. Wilson Tang, Matthias Dupont, Adrian F. Hernandez, Adriaan A. Voors, Amy P. Hsu, G. Michael Felker, Javed Butler, Marco Metra, Stefan D. Anker, Richard W. Troughton, Stephen S. Gottlieb, John J. McMurray, Paul W. Armstrong, Barry M. Massie, Robert M. Califf, Christopher M. O’Connor and Randall C. Starling
Table 2
Table 2
Baseline and Follow-Up (48- to 72-h) Cystatin C levels and Intermediate- and Long-Term Outcomes
| Endpoint | Unadjusted | Adjusted Model 1∗ | Adjusted Model 2† | |||
|---|---|---|---|---|---|---|
| OR/HR | p Value | OR/HR | p Value | OR/HR | p Value | |
| Baseline Cystatin C | ||||||
| Death at 30 days | 2.46 | <0.01 | 2.14 | 0.01 | 1.44 | 0.42 |
| Death/recurrent hospital stay at 30 days | 1.61 | <0.01 | 1.74 | <0.01 | 0.81 | 0.49 |
| Death at 180 days | 2.07 | <0.01 | 1.70 | <0.01 | 0.86 | 0.59 |
| Improved dyspnea at 6 h | 0.86 | 0.26 | 0.96 | 0.84 | 0.98 | 0.93 |
| Improved dyspnea at 24 h | 0.70 | 0.03 | 0.72 | 0.16 | 0.77 | 0.40 |
| Death or worsening heart failure prior to discharge | 2.09 | <0.01 | 2.28 | <0.01 | 1.04 | 0.93 |
| Length of stay‡∗ | 0.74 | <0.01 | 0.75 | <0.01 | 0.85 | 0.10 |
| Length of stay‡∗ (high vs. low) | 1.88 | <0.01 | 1.86 | <0.01 | 1.45 | 0.08 |
| Follow-up (48- to 72-h) Cystatin C | ||||||
| Death at 30 days | 2.63 | <0.01 | 2.91 | 0.13 | 2.25 | 0.26 |
| Death/recurrent hospital stay at 30 days | 1.65 | <0.01 | 1.31 | 0.45 | 1.27 | 0.53 |
| Death at 180 days | 2.07 | <0.01 | 1.37 | 0.33 | 1.30 | 0.43 |
| Length of stay‡∗ | 0.81 | <0.01 | 1.05 | 0.68 | 1.02 | 0.91 |
| Length of stay‡∗ (high vs. low) | 1.63 | <0.01 | 0.93 | 0.79 | 1.00 | 0.99 |
ASCEND-HF = Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure; BUN = blood urea nitrogen; HR = hazard ratio; OR = odds ratio.
↵∗ Adjusted model 1 = covariates derived from overall ASCEND-HF population excluding BUN and creatinine.
↵† Adjusted model 2 = covariates derived from overall ASCEND-HF population including BUN and creatinine.
↵‡ For length of stay, numerically lower hazard ratio equates to high risk for increased length of stay.
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