Cystatin C as Prognostic Biomarker in ST-Segment Elevation Acute Myocardial Infarction

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• 作者：Doroteia Silva ; MD^a ; ^&dagger ; ; ^{dojreis@hotmail.com} ; Nuno Cortez-Dias ; MD^a ; ^b ; ^c ; ^&dagger ; ; Clá ; udia Jorge ; MD^a ; J. Silva Marques ; MD^a ; Pedro Carrilho-Ferreira ; MD^a ; Andreia Magalhã ; es ; MD^a ; Susana R. Martins ; MD^a ; ^b ; Susana Gonç ; alves^a ; Pedro Canas da Silva ; MD^a ; Manuela Fiú ; za ; MD ; PhD^a ; ^b ; Antó ; nio Nunes Diogo ; MD^a ; ^b ; Fausto J. Pinto ; MD ; PhD^a ; ^b
• 刊名：The American Journal of Cardiology
• 出版年：2012
• 期刊代码：5_00029149
• 类别：med
• 出版时间：15 May, 2012
• 卷：109
• 期：10
• 页码：1431-1438
• 文件大小：1339 K

摘要

Cystatin C is a marker of renal dysfunction, and preliminary studies have suggested it might have a role as a prognostic marker in patients with coronary artery disease. The aim of the present study was to evaluate the usefulness of cystatin C for risk stratification of patients with ST-segment elevation myocardial infarction, regarding in-hospital and long-term outcomes. We 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 卤 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 卤 0.44 vs 0.69 卤 0.24 mg/L; p = 0.001). Long-term follow-up was available for 130 patients (583 卤 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 鈮?0%were independent predictors of the long-term risk of death, with synergistic interaction between the 2. In conclusion, 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.