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Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
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Cystatin C and risk of mortality among patients undergoing percutaneous coronary intervention

Fabio Angeli1, Paolo Verdecchia, Stefano Savonitto

  • 1Azienda Ospedaliera ed Universitaria di Perugia, Perugia, Italy.

Eurointervention : Journal of Europcr in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
|August 20, 2014
PubMed

Insights

Cystatin C better predicts death in coronary artery disease patients after percutaneous coronary intervention than estimated glomerular filtration rate (GFR). This finding highlights cystatin C

Area of Science:

  • Cardiology
  • Nephrology
  • Biomarkers

Background:

  • Coronary artery disease (CAD) patients undergoing percutaneous coronary intervention (PCI) face significant mortality risk.
  • Accurate prognostic markers are crucial for risk stratification in these patients.
  • Current markers like estimated glomerular filtration rate (eGFR) may have limitations.

Purpose of the Study:

  • To evaluate the prognostic value of cystatin C in predicting all-cause mortality in patients with CAD undergoing PCI.
  • To compare the predictive performance of cystatin C against eGFR derived from the Modification of Diet in Renal Disease (MDRD) formula.
  • To determine if cystatin C offers incremental predictive value over traditional markers.

Main Methods:

  • A cohort of 2,757 patients with documented CAD undergoing PCI were studied.
  • Cystatin C levels were measured pre-PCI.
  • Multivariable Cox regression and survival models were used to assess predictors of all-cause mortality over a median two-year follow-up.

Main Results:

  • Both eGFR and cystatin C were independent predictors of all-cause death.
  • Cystatin C demonstrated superior predictive ability (c-statistic: 0.794) compared to creatinine-based eGFR (c-statistic: 0.776, p=0.008).
  • Cystatin C significantly reclassified 15% of patients regarding their mortality risk (p=0.005) and was the sole significant predictor when both markers were included in the model.

Conclusions:

  • Cystatin C is a valuable prognostic biomarker for all-cause mortality in CAD patients undergoing PCI.
  • Cystatin C provides incremental predictive value beyond creatinine-based eGFR.
  • This study is the first to demonstrate the superior prognostic performance of cystatin C over the MDRD formula in this specific patient population.
Abstract

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