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The predictive value of plasma cystatin C for acute coronary syndrome treated with percutaneous coronary intervention
Tong-Wen Sun1, Qing-Yan Xu, Hai-Mu Yao
1Department of Integrated ICU, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, PR China.
Insights
High plasma cystatin C levels predict adverse cardiac events in patients undergoing percutaneous coronary intervention for acute coronary syndrome. Elevated cystatin C is an independent risk factor for major adverse cardiac events post-procedure.
Area of Science:
- Cardiology
- Biomarkers
- Interventional Cardiology
Background:
- Acute coronary syndrome (ACS) requires timely intervention.
- Percutaneous coronary intervention (PCI) is a common treatment for ACS.
- Predictive markers for adverse cardiac events post-PCI are crucial.
Purpose of the Study:
- To evaluate plasma cystatin C as a predictor of adverse cardiac events.
- To assess the prognostic value of cystatin C in ACS patients undergoing PCI.
- To determine if cystatin C levels correlate with cardiac event incidence.
Main Methods:
- 605 ACS patients undergoing successful PCI were enrolled.
- Plasma cystatin C measured pre-PCI, patients grouped by quartiles (Q1-Q4).
- Follow-up for major adverse cardiac events (MACE) over 14.3 months.
Main Results:
- Higher cystatin C quartiles (Q2-Q4) showed increased MACE incidence vs. Q1.
- Elevated cystatin C independently predicted MACE via Cox regression.
- Q3 and Q4 groups had lower cumulative survival rates.
Conclusions:
- High plasma cystatin C is an independent predictor of MACE in ACS patients post-PCI.
- Cystatin C can aid in risk stratification for these patients.
- Monitoring cystatin C may improve patient management strategies.
Background:
This study was designed to evaluate the value of plasma cystatin C in predicting adverse cardiac events after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS).
Methods:
A total of 605 patients (404 male, mean age 60.4 ± 10.6 years) with ACS underwent successful PCI. Patients were divided into 4 groups according to the level of cystatin C, which was measured before the PCI: Q1 (<1.02 mg/L), Q2 (1.02-1.16 mg/L), Q3 (1.17-1.34 mg/L), and Q4 (≥1.35 mg/L).
Results:
After a follow-up of 14.3 ± 1.7 months, the incidence of mortality, nonfatal myocardial infarction, and target lesion revascularization in the Q2, Q3, and Q4 groups was higher than in the Q1 group (P < .001). The incidence of heart failure in the Q3 and Q4 groups was higher than in the Q1 group (P < .05). Multivariate Cox regression analysis showed that cystatin C elevation was an independent predictor of major adverse cardiac events. The cumulative survival rate of the Q3 and Q4 groups was lower than in the Q1 group (P < .001).
Conclusion:
High plasma cystatin C concentration is an independent predictor of major adverse cardiac events in patients with ACS treated with PCI.
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