Cystatin C as prognostic biomarker in ST-segment elevation acute myocardial infarction
The American Journal of Cardiology, 05/21/2012
Silva D et al. – Cystatin C is a new biomarker with significant added prognostic value for patients with ST–segment elevation myocardial infarction undergoing primary percutaneous coronary intervention, predicting both short– and long–term outcomes.Methods
- Authors included 153 consecutive patients with ST–segment elevation myocardial infarction treated by primary angioplasty.
- The baseline cystatin C level was measured at coronary angiography.
- The in–hospital outcome was determined as progression to cardiogenic shock or in–hospital death, and the long–term outcome was assessed, considering the following end points: (1) death and (2) death or reinfarction.
- Of the 153 patients evaluated (age 61 ± 12 years; 75.6% men), 15 (14.4%) progressed to cardiogenic shock and 4 (2.7%) died during hospitalization.
- The patients who progressed to cardiogenic shock or died during hospitalization had significantly greater cystatin C levels (1.02 ± 0.44 vs 0.69 ± 0.24 mg/L; p = 0.001).
- Long–term follow–up was available for 130 patients (583 ± 163 days).
- Among them, 11 patients died and 7 had reinfarction.
- A high baseline cystatin C level was associated with an increased risk of death (hazard ratio 8.5; p = 0.009) and death or reinfarction (hazard ratio 3.89; p = 0.021).
- Furthermore, only high baseline cystatin C levels and left ventricular ejection fraction ≤40% were independent predictors of the long–term risk of death, with synergistic interaction between the 2.