Cystatin C is associated with risk of venous thromboembolism in subjects with normal kidney function – the Tromsø study

• Published in: Haematologica (Roma) Vol. 97; no. 7; pp. 1008 - 1013
• Main Authors: Brodin, E. E., Braekkan, S. K., Vik, A., Brox, J., Hansen, J.-B.
• Format: Journal Article
• Language: English
• Published: Pavia Ferrata Storti Foundation 01.07.2012
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Biomarkers - blood; Blood and lymphatic vessels; Cardiology. Vascular system; Clinical medical disciplines: 750; Community medicine, Social medicine: 801; Creatinine - urine; Cystatin C - blood; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; Glomerular Filtration Rate; Health sciences: 800; Helsefag: 800; Hematologi: 775; Hematologic and hematopoietic diseases; Hematology: 775; Humans; Kidney - metabolism; Kidney - physiopathology; Klinisk medisinske fag: 750; Male; Medical disciplines: 700; Medical sciences; Medisinske Fag: 700; Middle Aged; Original and Brief Reports; Prognosis; Proportional Hazards Models; Prospective Studies; Risk; Samfunnsmedisin, sosialmedisin: 801; VDP; Venous Thromboembolism - blood; Venous Thromboembolism - diagnosis; Venous Thromboembolism - physiopathology; Human; Renal function; Hematology; VTE; Deep vein thrombosis; Cardiovascular disease; Venous disease; Vascular disease; venous thromboembolism; Risk factor; Cystatin C; Venous thrombosis; risk; Thromboembolism
• ISSN: 0390-6078; 1592-8721; 1592-8721
• DOI: 10.3324/haematol.2011.057653

Previous studies have shown an association between impaired kidney function, assessed by cystatin C-based estimated glomerular filtration rate, and venous thromboembolism. The aim of this study was to investigate whether serum cystatin C was associated with a risk of venous thromboembolism among subjects with normal kidney function in a prospective population-based study. Cystatin C was measured in serum from 3251 men and women with normal kidney function, aged 25-84 years, who participated in the Tromsø study in 1994-1995. Normal kidney function was defined as a creatinine-based estimated glomerular filtration rate greater than 90 mL/min/1.73 m(2) and absence of microalbuminuria. Incident venous thromboembolism was registered from the date of inclusion through to the end of follow-up, September 1, 2007. Cox-regression models were used to calculate hazard ratios with 95% confidence intervals for venous thromboembolism. There were 83 incident venous thromboembolic events, of which 53 (63.9 %) were provoked, during a median of 12.3 years of follow-up. A one standard deviation (0.11 mg/L) increase in serum cystatin C levels was associated with a 43% (hazard ratio 1.43; 95% confidence interval 1.17-1.72) increased risk of total venous thromboembolism. Subjects with cystatin C levels in the top quartile (≥ 0.87 mg/L) had a 2.5-fold (hazard ratio 2.51; 95% confidence interval 1.27-4.96) increased risk of venous thromboembolism compared to those with levels in the bottom quartile (≤ 0.72 mg/L) in adjusted analysis. The risk estimates were even higher for provoked venous thromboembolism (hazard ratio 3.11; 95% confidence interval 1.23-7.86). Serum cystatin C levels were associated with the risk of venous thromboembolism in subjects with normal kidney function. Our findings suggest that elevated serum cystatin C levels may promote venous thrombosis beyond reflecting impaired kidney function.