ABSTRACT
Aims: cystatin C is an endogenous marker of renal function. It is a well established better marker of glomerular filtration rate than serum creatinine. There is also evidence that cystatin C is associated with atherosclerotic disease. The present prospective study evaluated the prognostic value of cystatin C after myocardial infarction in patients without chronic kidney disease
Methods and results: a total of 127 patients who underwent coronary angiography after an acute coronary syndrome [ACS] were included. Cystatin C was associated with the severity of coronary artery disease [CAD]. Cystatin C levels were significantly higher in patients with 3-vessels disease and severe CAD according to GENSINI score [p = 0.01 and p < 0.001 respectively]. Among the patients admitted for ST elevation myocardial infarction, Cystatin C concentration was correlated with the initial TIMI flow in the culprit artery [p < 0.001]. Mean duration of the follow-up period was 10.76 [thorn] 2.1 months. High Cystatin C concentrations were associated to the occurrence of unfavourable outcomes and cardiovascular mortality during follow-up [1.19 [thorn] 0.4 vs. 1.01 [thorn] 0.35 mg/L, p = 0.01 and 1.21 [thorn] 0.36 vs. 0.96 [thorn] 0.27 mg/L, p = 0.03]. Among different laboratory parameters, cystatin C was the best marker to predict the occurrence of major adverse cardiovascular events during the follow-up [Area under the receiveroperating characteristic curve = 0.743]
Conclusion: high cystatin C levels are associated with the severity of coronary artery disease in patients presenting an acute coronary syndrome and a normal renal function. Cystatin C is also associated to unfavourable cardiovascular outcomes during follow-up and appears as a strong predictor for risk of cardiovascular events and death