{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T17:41:19Z","timestamp":1760550079598,"version":"3.41.2"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2016,6,13]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Cystatin C is associated with both renal function and atherosclerotic cardiovascular disease (\n              <jats:styled-content style=\"fixed-case\">ASCVD<\/jats:styled-content>\n              ). We have previously shown a genetic correlation between cystatin C and prevalent\n              <jats:styled-content style=\"fixed-case\">ASCVD<\/jats:styled-content>\n              . The objective of this article is to study whether variation in cystatin C or creatinine predicts incident\n              <jats:styled-content style=\"fixed-case\">ASCVD<\/jats:styled-content>\n              when controlled for genetic factors.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The predictive value of cystatin C and creatinine for incident\n              <jats:styled-content style=\"fixed-case\">ASCVD<\/jats:styled-content>\n              was studied in 11\u00a0402 Swedish twins, free of\n              <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content>\n              at baseline, in an adjusted Cox\u2010regression model during a median follow\u2010up of 71\u00a0months. Twin pairs discordant for incident stroke, myocardial infarction and\n              <jats:styled-content style=\"fixed-case\">ASCVD<\/jats:styled-content>\n              during follow\u2010up were identified and within\u2010pair comparisons regarding cystatin C and creatinine levels were performed. We also investigated whether contact frequency and degree of shared environment influences were associated with similarity in cystatin C levels. In univariate analysis, cystatin C predicted incident\n              <jats:styled-content style=\"fixed-case\">ASCVD<\/jats:styled-content>\n              hazard ratio 1.57, 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              1.47\u20131.67. When adjusted for traditional Framingham risk factors as covariates, cystatin C remained a predictor of incident stroke hazard ratio 1.45, 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              (1.25\u20131.70),\n              <jats:styled-content style=\"fixed-case\">ASCVD<\/jats:styled-content>\n              hazard ratio 1.26, 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              (1.13\u20131.41), and myocardial infarction hazard ratio 1.16, 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              (1.01\u20131.33). In twins discordant for incident stroke, cystatin C at baseline was higher in the twin who experienced a stroke compared to the healthy co\u2010twin (1.11\u00b10.3\u00a0mg\/L versus 1.06\u00b10.3\u00a0mg\/L), whereas creatinine was lower in the twin who developed\n              <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content>\n              compared to their healthy co\u2010twins (76.1\u00b116.9\u00a0\u03bcmol\/L versus 79.4\u00b120.3\u00a0\u03bcmol\/L).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Variation in cystatin C relates to incident\n              <jats:styled-content style=\"fixed-case\">ASCVD<\/jats:styled-content>\n              and to stroke when adjusted for genetic confounding. In identical twins, cystatin C may be a sensitive marker of early hypertensive end\u2010organ damage and small\u2010vessel disease, whereas creatinine level may reflect nutritional status. The findings in disease\u2010discordant monozygotic twins indicate that unique, possibly preventable, environmental factors are important.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.115.003085","type":"journal-article","created":{"date-parts":[[2016,6,29]],"date-time":"2016-06-29T17:54:51Z","timestamp":1467222891000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Cystatin C Predicts Incident Cardiovascular Disease in Twins"],"prefix":"10.1161","volume":"5","author":[{"given":"Johannes","family":"Arpeg\u00e5rd","sequence":"first","affiliation":[{"name":"Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden"},{"name":"Department of Emergency Medicine, Karolinska University Hospital Solna, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrik K. 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