Increased Cystatin C Level in ST-Elevation Myocardial Infarction Predisposes the Prognosis of Angioplasty

Am J Med Sci. 2018 Jun;355(6):530-536. doi: 10.1016/j.amjms.2018.03.003. Epub 2018 Mar 5.

Abstract

Background: The study aimed to evaluate the prognostic value of cystatin C in ST-elevation acute myocardial infarction (STEMI) patients who underwent elective percutaneous coronary intervention (PCI).

Methods: A retrospective study was conducted on 664 STEMI patients from 7 centers who were treated with elective PCI. These patients were divided into 3 groups according their admission cystatin C levels as < 0.84, 0.84-1.03 and ≥1.04mg/L. The all-cause mortalities and the composite endpoints, including mortality, reinfarction, rehospitalization for heart failure and angina or repeat target vessel revascularization were observed for up to 5 years.

Results: As cystatin C levels from low to high, all-cause mortalities were progressively increased 0.9%, 3.7% and 9.5% (P < 0.001), as well as the composite endpoints, 11.1%, 21.7% and 40.7%, respectively (P < 0.001). When patients had the level of cystatin C ≥0.84mg/L, their risks of composite endpoints increased 2- to 3-fold of those with <0.84mg/L, with the adjusted hazard ratio of 2.096 (95% CI: 1.047-4.196, P = 0.037) and 3.608 (95% CI: 1.939-6.716, P < 0.001), respectively.

Conclusions: Increased cystatin C levels may be associated with enhanced risks of composite endpoints in patients with STEMI undergoing elective PCI.

Keywords: Cystatin C; Elective percutaneous coronary intervention; Prognosis; ST-elevation acute myocardial infarction.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Aged
  • Angina, Unstable / therapy
  • Angioplasty*
  • Coronary Angiography
  • Cystatin C / blood*
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Genetic Predisposition to Disease
  • Heart Failure / therapy
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Patient Readmission
  • Percutaneous Coronary Intervention
  • Prognosis
  • Retrospective Studies
  • ST Elevation Myocardial Infarction / surgery*

Substances

  • Cystatin C