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Published on: May 28, 2019
High cystatin C levels predict long-term mortality in patients with ST-segment elevation myocardial infarction
Yuewu Chen1,2, Yan Fan3, Min Men4
1Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Insights
High admission cystatin C levels predict long-term mortality in ST-segment elevation myocardial infarction (STEMI) patients undergoing late percutaneous coronary intervention (PCI). This finding aids in risk stratification for these individuals.
Area of Science:
- Cardiology
- Biomarkers
- Clinical Medicine
Background:
- Late percutaneous coronary intervention (PCI) is a common treatment for ST-segment elevation myocardial infarction (STEMI).
- Predicting long-term mortality in STEMI patients receiving late PCI is crucial for patient management.
- Cystatin C (cys C) is a potential biomarker for cardiovascular risk.
Purpose of the Study:
- To evaluate the predictive value of admission cystatin C (cys C) levels on long-term mortality.
- To assess the role of cys C in STEMI patients undergoing late PCI.
Main Methods:
- Retrospective analysis of 716 STEMI patients who received late PCI (PCI > 7 days from symptom onset).
- Cystatin C levels were measured at admission; a threshold of ≥1.105 mg/L was identified.
- Long-term mortality was assessed through follow-up interviews and medical record review.
Main Results:
- Patients with high cys C levels (≥1.105 mg/L) showed significantly higher long-term all-cause mortality (10.4% vs 2.9%) and cardiac mortality (6.8% vs 2.1%) compared to those with low cys C levels.
- Multivariate Cox regression confirmed high cys C level as an independent predictor of both all-cause and cardiac mortality.
Conclusions:
- Admission cystatin C level is a valuable independent predictor of long-term mortality.
- High cys C levels identify STEMI patients undergoing late PCI at increased risk for adverse outcomes.
- This biomarker can aid in risk stratification and personalized treatment strategies.
Objectives:
Late percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI), defined as time of PCI > 7 days from symptom onset, is a common practice with clinical benefits. This study aimed to evaluate the predictive value of admission cystatin C (cys C) level on long-term mortality in STEMI patients receiving late PCI.
Methods:
Medical records of STEMI patients who were hospitalized between 2009 and 2011 from eight PCI-capable hospitals in Northwest China were retrospectively analyzed. Cys C level ≥ 1.105 mg/L was considered as the best predictor of long-term mortality based on the receiver-operating characteristic analysis. Patients were followed up by phone or face-to-face interviews, and the long-term mortality was obtained by reviewing medical records.
Results:
The final analysis included 716 STEMI patients who received late PCI and had available cys C levels prior to PCI, and 524 were assigned into the high cys C group and 192 the low cys C group. Patients were followed up for an average length of 40.37 months. Compared with the low cys C group, the high cys C group had a higher long-term all-cause mortality (10.4% vs 2.9%, P < 0.001) and a higher cardiac mortality (6.8% vs 2.1%, P = 0.004). Multivariate Cox regression analysis showed that high cys C level was an independent predictor for both long-term all-cause mortality and cardiac mortality.
Conclusions:
High cys C level at admission is an independent predictor of long-term mortality in STEMI patients undergoing late PCI.
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