Prediction of Outcomes Through Cystatin C and cTnI in Elderly Type 2 Myocardial Infarction Patients

Clin Interv Aging. 2023 Aug 25:18:1415-1422. doi: 10.2147/CIA.S416372. eCollection 2023.

Abstract

Background: Chronic kidney disease (CKD) and coronary artery disease (CAD) are strongly associated. Cystatin C (Cys C) is a more sensitive marker of early renal insufficiency. This study aimed to evaluate the prognostic implications of combined of Cys C and cardiac troponin I (cTnI) on 90-day outcomes in elderly patients with type 2 myocardial infarction (MI).

Methods: The data of consecutive type 2 MI patients aged 80 years and older who received Cys C and cTnI measurements within 24 h of admission were retrospectively reviewed. The endpoint was a 90-day all-cause and cardiac mortality.

Results: A total of 4326 patients were included. During the 90-day follow-up period, a higher all-cause and cardiac mortality was observed in patients with Cys C ≥ 1.49mg/L than in patients with Cys C < 1.49 mg/L (P <0.001). After the multivariate logistic regression adjustments, the higher CysC and cTnI levels remained independent predictors of the 90-day all-cause mortality and cardiac mortality. Moreover, the Kaplan-Meier all-cause and cardiac mortality event-free survival curves showed that the patients with the presence of elevated levels of both Cys C and cTnI had a significantly increased risk than those with Cys C or cTnI alone.

Conclusion: Elevated Cys C level is an independent risk factor for all-cause and cardiac mortality in the elderly type 2 MI population. The predictive ability of the combined use of Cys C and cTnI in elderly type 2 MI patients is stronger than that of Cys C or cTnI alone.

Keywords: cystatin C; elderly; myocardial infarction.

MeSH terms

  • Aged
  • Coronary Artery Disease*
  • Cystatin C
  • Humans
  • Myocardial Infarction*
  • Retrospective Studies
  • Troponin I

Substances

  • Cystatin C
  • Troponin I

Grants and funding

Research reported in this article was supported by Public Service Platform Project of Industrial Technology Foundation, China under grant number 2020-0103-3-1-2. The funding organization had no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.