{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T14:50:26Z","timestamp":1783349426616,"version":"3.54.6"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,1,11]]},"abstract":"\n Background<\/jats:title>\n \n Contrast\u2010induced acute kidney injury (\n CI<\/jats:styled-content>\n \u2010\n AKI<\/jats:styled-content>\n ) was traditionally defined as an increase in serum creatinine (\n sC<\/jats:styled-content>\n r) after contrast media exposure. Recently, serum cystatin C (\n sCyC<\/jats:styled-content>\n ) has been proposed as an alternative to detect acute changes in renal function. The clinical implications of combining\n sCyC<\/jats:styled-content>\n and\n sC<\/jats:styled-content>\n r to diagnose\n CI<\/jats:styled-content>\n \u2010\n AKI<\/jats:styled-content>\n remain unknown.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n One thousand seventy\u2010one consecutive patients undergoing coronary angiography\/intervention were prospectively enrolled.\n SC<\/jats:styled-content>\n yC and\n sC<\/jats:styled-content>\n r were assessed at baseline and 24 to 48\u00a0hours after contrast media exposure.\n CI<\/jats:styled-content>\n \u2010\n AKI<\/jats:styled-content>\n determined by\n sC<\/jats:styled-content>\n r (\n CI<\/jats:styled-content>\n \u2010\n AKI<\/jats:styled-content>\n sCr<\/jats:sub>\n ) was defined as an\n sC<\/jats:styled-content>\n r increase greater than 0.3\u00a0mg\/dL or 50% from baseline. Major adverse events at 12\u00a0months were assessed.\n CI<\/jats:styled-content>\n \u2010\n AKI<\/jats:styled-content>\n sCr<\/jats:sub>\n developed in 25 patients (2.3%). Twelve\u2010month follow\u2010up was available for 1063 patients; major adverse events occurred in 61 patients (5.7%). By receiver operating characteristic curve analysis, an\n sCyC<\/jats:styled-content>\n increase of greater than 15% was the optimal cutoff for\n CI<\/jats:styled-content>\n \u2010\n AKI<\/jats:styled-content>\n sCr<\/jats:sub>\n detection, which occurred in 187 patients (17.4%). To evaluate the use of both\n sCyC<\/jats:styled-content>\n and\n sC<\/jats:styled-content>\n r as\n CI<\/jats:styled-content>\n \u2010\n AKI<\/jats:styled-content>\n diagnostic criteria, we stratified patients into 3 groups: no\n CI<\/jats:styled-content>\n \u2010\n AKI<\/jats:styled-content>\n ,\n CI<\/jats:styled-content>\n \u2010\n AKI<\/jats:styled-content>\n detected by a single marker, and\n CI<\/jats:styled-content>\n \u2010\n AKI<\/jats:styled-content>\n detected by both markers. Multivariable logistic regression revealed that the predictability of major adverse events increased in a stepwise fashion in the 3 groups (no\u2010\n CI<\/jats:styled-content>\n \u2010\n AKI<\/jats:styled-content>\n group as the reference,\n CI<\/jats:styled-content>\n \u2010\n AKI<\/jats:styled-content>\n detected by a single marker: odds ratio=2.25, 95%\n CI<\/jats:styled-content>\n : 1.24\u20134.10,\n P<\/jats:italic>\n <0.01;\n CI<\/jats:styled-content>\n \u2010\n AKI<\/jats:styled-content>\n detected by both markers: odds ratio=10.00, 95%\n CI<\/jats:styled-content>\n : 3.13\u201331.91,\n P<\/jats:italic>\n <0.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Combining\n sCyC<\/jats:styled-content>\n and\n sC<\/jats:styled-content>\n r to diagnose\n CI<\/jats:styled-content>\n \u2010\n AKI<\/jats:styled-content>\n would be beneficial for risk stratification and prognosis in patients after contrast media exposure.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.116.004747","type":"journal-article","created":{"date-parts":[[2017,1,14]],"date-time":"2017-01-14T03:00:35Z","timestamp":1484362835000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":21,"title":["Use of Both Serum Cystatin C and Creatinine as Diagnostic Criteria for Contrast\u2010Induced Acute Kidney Injury and Its Clinical Implications"],"prefix":"10.1161","volume":"6","author":[{"given":"Wei\u2010feng","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuo","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ding","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Johns Hopkins University, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi\u2010qun","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao\u2010lei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi\u2010chun","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling\u2010hong","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"He","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.114.002475"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.12.035"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.116.004138"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfs375"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-011-2225-0"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.06350909"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfq176"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1053\/ajkd.2002.34487"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.5414\/CNP61098"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.5414\/CNP62241"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ki.5002729"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.06.068"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/80.1.27"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu063"},{"key":"e_1_3_3_16_2","first-page":"85","article-title":"Incidence and risk of developing contrast\u2010induced acute kidney injury following intravascular contrast administration in elderly patients","volume":"9","author":"Song W","year":"2014","unstructured":"Song W, Zhang T, Pu J, Shen L, He B. 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