Cystatin C as a predictor of all-cause mortality and myocardial infarction in patients with non-ST-elevation acute coronary syndrome |
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| Authors: | Ristiniemi Noora Lund Juha Tertti Risto Christensson Anders Ilva Tuomo Porela Pekka Pulkki Kari Pettersson Kim |
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| Institution: | 1. Department of Biotechnology, University of Turku, Tykistökatu 6A, 20520 Turku, Finland;2. Department of Medicine, Turku University Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland;3. Department of Nephrology and Transplantation, Lund University, Skåne University Hospital, 20502 Malmö, Sweden;4. Heart Center, Tampere University Hospital, Teiskontie 35, 33520 Tampere, Finland;5. Department of Clinical Chemistry, University of Eastern Finland, Kuopio, Finland, and Eastern Finland Laboratory Centre, PO Box 1700, 70211 Kuopio, Finland;1. Department of Cardiothoracic Surgery, Anesthesia and Intensive Care, Skane University Hospital, Lund, Sweden;2. Lund University, Department of Clinical Sciences, Lund, Cardiothoracic Surgery, Lund, Sweden;3. Department of Heart Failure and Valvular Disease, Skane University Hospital, Lund, Sweden;4. Lund University, Department of Clinical Sciences, Lund, Cardiology, Lund, Sweden;1. Division of Genetic Epidemiology, Department of Medical Genetics, Molecular and Clinical Pharmacology, Medical University of Innsbruck, Innsbruck, Austria;2. Department of Vascular Surgery, Medical University of Innsbruck, Innsbruck, Austria;3. 3rd Medical Department of Metabolic Diseases and Nephrology, Hietzing Hospital, Vienna, Austria;4. King''s College London, Diabetes Research Group, London, United Kingdom;5. Central Institute of Medical and Chemical Laboratory Diagnostics, University Hospital Innsbruck, Medical University of Innsbruck, Innsbruck, Austria;6. Clinic for Angiology, HELIOS Klinikum Berlin-Buch, Berlin, Germany;1. Department of Surgery, Pippu Clinic, 2-10, 1 cyome Nakamachi, Pippu, Town Kamikawa-gun, Hokkaido 078-0343, Japan;2. Department of Surgery, Asahikawa Medical University, 1-1, 2-1, Midorigaoka, Asahikawa City 078-8510, Japan;3. Department of Gastroenterology and Hepatology, Okayama University, 2-5-1, Shikata Town, Okayama City, Okayama 700-8558, Japan;4. Department of Surgery, Asahikawa Medical Center, 4048, 7 cyome, Hanasaki-cyo, Asahikawa City 070-8644, Japan;5. Department of Surgery, Hokuyu Hospital, 5-1, 6-6 Higashi-Sappro, Shiroishi-ku, Sapporo City 003-0006, Japan;6. Department of Surgery, Nihon University, 1-8-13 Surugadai Kanda, Chiyoda-ku, Tokyo 010-8309, Japan;7. Department of Internal Medicine, Asahikawa Medical University, 1-1, 2-1, Midorigaoka, Asahikawa City 078-8510, Japan;8. Department of Radiology, Jikei University, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan |
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| Abstract: | ObjectivesTo investigate the predictive value of cystatin C among patients diagnosed with non-ST-elevation acute coronary syndrome (nSTE-ACS).Design and methodsAdmission serum samples from 245 nSTE-ACS patients were measured with a novel cystatin C immunoassay based on a dry-reagent, double monoclonal design. Creatinine concentrations, estimated glomerular filtration rates (eGFR) and one-year follow-up data were available for these patients.ResultsDuring the follow-up period, 34 (14%) of patients had myocardial infarction (MI) and 25 (11%) died. Increased serum cystatin C was an independent predictor of all-cause mortality and combined events (all-cause mortality and MI) after adjustment to non-biomarker baseline factors, hazard ratio (HR) 2.19 (per increase of 1 tertile; 95% Cl 1.28–3.78, p = 0.0046) and 1.75 (1.22–2.51, p = 0.0024), respectively. Corresponding values for eGFR were 2.56 (1.43–4.59, p = 0.0016) and 1.76 (1.23–2.53, p = 0.0022), respectively. Creatinine was not an independent predictor of endpoints (p > 0.05).ConclusionsCystatin C was associated with an increased risk of death and combined events in patients with nSTE-ACS. |
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