Prognostic significance of cystatin C in patients with ST-elevation myocardial infarction

Circ J. 2009 Sep;73(9):1669-73. doi: 10.1253/circj.cj-08-0943. Epub 2009 Jul 13.

Abstract

Background: Cystatin C is reportedly a better endogenous marker of glomerular filtration rate than serum creatinine, so the prognostic value of cystatin C in patients with ST-elevation myocardial infarction (MI) was evaluated in the present study.

Methods and results: A total of 71 patients who underwent percutaneous coronary intervention for ST-segment elevation MI <24 h from symptom onset were included. According to cystatin C level, patients were classified into 2 groups: (1) higher cystatin C group (n=33) and (2) lower cystatin C group (n=38). There was a trend toward more in-hospital deaths in patients with the higher cystatin C level compared with the lower cystatin C level group (15.2% vs 2.6%, P=0.06). Mean duration of clinical follow-up was 5.6 +/-2.8 months. There was no significant difference in death, reinfarction, disabling stroke or target lesion revascularization between the 2 groups. However, a higher incidence of rehospitalization for congestive heart failure was observed in patients with the higher cystatin C level than in those with the lower cystatin C level (15.2% vs 0%, P=0.01).

Conclusions: Cystatin C may be associated with more cardiovascular events, mainly rehospitalization for congestive heart failure, after percutaneous coronary intervention in patients with ST-elevation MI.

MeSH terms

  • Aged
  • Angioplasty, Balloon, Coronary* / adverse effects
  • Angioplasty, Balloon, Coronary* / mortality
  • Biomarkers / blood
  • Coronary Angiography
  • Coronary Thrombosis / blood
  • Coronary Thrombosis / etiology
  • Creatinine / blood
  • Cystatin C / blood*
  • Female
  • Glomerular Filtration Rate*
  • Heart Failure / blood
  • Heart Failure / etiology
  • Hospital Mortality
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Myocardial Infarction / blood
  • Myocardial Infarction / complications
  • Myocardial Infarction / diagnostic imaging
  • Myocardial Infarction / mortality
  • Myocardial Infarction / therapy*
  • Patient Readmission
  • Predictive Value of Tests
  • Proportional Hazards Models
  • ROC Curve
  • Recurrence
  • Renal Insufficiency / blood
  • Renal Insufficiency / complications*
  • Renal Insufficiency / mortality
  • Renal Insufficiency / physiopathology
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Stroke / blood
  • Stroke / etiology
  • Time Factors
  • Treatment Outcome

Substances

  • Biomarkers
  • CST3 protein, human
  • Cystatin C
  • Creatinine