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Predictive value of cystatin C in people with suspected or established coronary artery disease: A meta-analysis

Shaohui Yang1, Luorui Song1, Lei Zhao2

  • 1Department of Cardiology, The First Affiliated Hospital and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, 471003, China.

Atherosclerosis
|June 10, 2017
PubMed

Insights

Elevated circulating cystatin C is a significant predictor of adverse vascular outcomes, including all-cause and cardiovascular mortality, in individuals with coronary artery disease (CAD). This finding holds true regardless of kidney function.

Area of Science:

  • Cardiovascular Medicine
  • Biomarkers
  • Epidemiology

Background:

  • Circulating cystatin C is an established predictor of mortality in the general population.
  • Its prognostic value in patients with coronary artery disease (CAD) requires further elucidation.

Purpose of the Study:

  • To evaluate the prognostic significance of baseline circulating cystatin C levels in individuals with suspected or established CAD.
  • To conduct a meta-analysis to consolidate evidence on cystatin C as a predictor of adverse vascular outcomes.

Main Methods:

  • A systematic meta-analysis was performed on prospective observational studies.
  • Literature search was conducted in Pubmed and Embase databases up to October 2016.
  • Adverse vascular outcomes included all-cause mortality, cardiovascular mortality, and total adverse vascular events.

Main Results:

  • Ten studies with participants having known or suspected CAD were included.
  • Higher cystatin C levels were associated with increased risk: HR 2.27 for all-cause mortality, 2.24 for cardiovascular mortality, and 1.87 for total adverse vascular events.
  • Subgroup analyses indicated no influence of follow-up duration, region, or CAD type on the association.

Conclusions:

  • Elevated circulating cystatin C is an independent predictor of adverse vascular outcomes in patients with suspected or established CAD.
  • The association encompasses all-cause mortality, cardiovascular mortality, and total adverse vascular events.
  • This predictive value appears independent of creatinine and estimated glomerular filtration rate.
Abstract

Keywords:
Coronary artery diseaseCystatin CMeta-analysisMortalityVascular events

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