Cystatin C as a predictor of all-cause mortality and myocardial infarction in patients with non-ST-elevation acute coronary syndrome

Ristiniemi, Noora; Lund, Juha; Tertti, Risto; Christensson, Anders; Ilva, Tuomo; Porela, Pekka; Pulkki, Kari; Pettersson, Kim

doi:10.1016/j.clinbiochem.2012.02.012

Cited by 34 publications

(25 citation statements)

References 35 publications

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“…Akgul et al investigated the association of cystatin C with inhospital and post-discharge complications in 475 patients with STEMI who had undergone primary PCI [19]. In that study, similar to the current study findings and another study by Ristiniemi, the mean age was higher in the high cystatin C group [20]. Older patients with coronary artery disease can be assumed to have an increased inflammatory burden, DM associated with increased age, and increased malnutrition.…”

Section: Discussionsupporting

confidence: 87%

May cystatin-c be associated with post-myocardial infarction complications?

Taşçanov¹

2019

Ann Clin Anal Med

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Aim: Decreased cystatin C increases proteolytic effects of cathepsin contributing to plaque rupture. We aimed to investigate the association of cystatin C levels with in-hospital and post-discharge cardiac events in patients with acute myocardial infarction (AMI). Material and Method: We included 85 patients with AMI. Patients with cancer, systemic diseases, increased creatinine, active infection or aortic aneurysm were excluded. Demographic data, laboratory and echocardiographic parameters were analyzed. Serum cystatin C levels were measured in before coronary angiography. Results: Non-ST elevation myocardial infarction was determined in 32.94% of the patients. There were no differences between the normal and high cystatin C groups in terms of gender, diagnosis, obesity, hypertension, hyperlipidemia, cigarette smoking, Killip classification, preference of primary percutaneous coronary intervention or thrombolytic therapy, frequencies of culprit coronary arteries or the number of obstructed arteries. Diabetes mellitus was more frequent in the high cystatin C group. Complication rates after AMI were similar in both the normal and high cystatin C groups on the 5th day and the 12th month. Mean age was higher in the high cystatin C group. ESR, low density lipoprotein (LDL) and total cholesterol were found to be significantly higher in the high cystatin C group. The optimum cut-off values for ESR, LDL and total cholesterol were 11, 88.6, and 161.5, respectively; diagnostic accuracies were adequate. Discussion: The results of the study showed that ESR, LDL and total cholesterol were higher in high cystatin C group, but complications were similar in both groups. We concluded that cystatin C was not a predictor for post-AMI complications at 12th month.

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Section: Discussionsupporting

confidence: 87%

May cystatin-c be associated with post-myocardial infarction complications?

Taşçanov¹

2019

Ann Clin Anal Med

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“…All biomarkers investigated in the present study, except for FGF23, have been linked to adverse outcomes in NSTE-ACS (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)23 ). FGF23 is emerging as a prognostic biomarker in chronic kidney disease (35 ) and stable coronary artery disease (36 ), which prompted us to explore it for the first time in NSTE-ACS.…”

Section: Discussionmentioning

confidence: 99%

Incremental Prognostic Value of Biomarkers beyond the GRACE (Global Registry of Acute Coronary Events) Score and High-Sensitivity Cardiac Troponin T in Non-ST-Elevation Acute Coronary Syndrome

et al. 2013

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BACKGROUND Guidelines recommend the use of validated risk scores and a high-sensitivity cardiac troponin assay for risk assessment in non-ST-elevation acute coronary syndrome (NSTE-ACS). The incremental prognostic value of biomarkers in this context is unknown. METHODS We calculated the Global Registry of Acute Coronary Events (GRACE) score and measured the circulating concentrations of high-sensitivity cardiac troponin T (hs-cTnT) and 8 selected cardiac biomarkers on admission in 1146 patients with NSTE-ACS. We used an hs-cTnT threshold at the 99th percentile of a reference population to define increased cardiac marker in the score. The magnitude of the increase in model performance when individual biomarkers were added to GRACE was assessed by the change (Δ) in the area under the receiver-operating characteristic curve (AUC), integrated discrimination improvement (IDI), and category-free net reclassification improvement [NRI(>0)]. RESULTS Seventy-eight patients reached the combined end point of 6-month all-cause mortality or nonfatal myocardial infarction. The GRACE score alone had an AUC of 0.749. All biomarkers were associated with the risk of the combined end point and offered statistically significant improvement in model performance when added to GRACE (likelihood ratio test P ≤ 0.015). Growth differentiation factor 15 [ΔAUC 0.039, IDI 0.049, NRI(>0) 0.554] and N-terminal pro–B-type natriuretic peptide [ΔAUC 0.024, IDI 0.027, NRI(>0) 0.438] emerged as the 2 most promising biomarkers. Improvements in model performance upon addition of a second biomarker were small in magnitude. CONCLUSIONS Biomarkers can add prognostic information to the GRACE score even in the current era of high-sensitivity cardiac troponin assays. The incremental information offered by individual biomarkers varies considerably, however.

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“…Serum levels are regarded as a strong marker of kidney function, 29 but cystatin C is also associated with CVD independently of renal disease. 30,31 Serum cystatin C has been established as a predictor of cardiovascular events and mortality in patients with non-ST-elevation ACS, 32,33 ST-elevation myocardial infarction, 34 and suspected ACS, 35 but also in the general population 36 and elderly persons. 37 Although the predictive potential in CVD seems to be high, the diagnostic value of cystatin C for acute myocardial ischaemia remains unexplored so far.…”

Section: Discussionmentioning

confidence: 99%

Serum extracellular vesicle protein levels are associated with acute coronary syndrome

Hoog

Timmers

Schoneveld

et al. 2012

European Heart Journal: Acute Cardiovascular Care

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Aims: Biomarkers are essential in the early detection of acute coronary syndromes (ACS). Serum extracellular vesicles are small vesicles in the plasma containing protein and RNA and have been shown to be involved in ACS-related processes like apoptosis and coagulation. Therefore, we hypothesized that serum extracellular vesicle protein levels are associated with ACS. Methods and results: Three serum extracellular vesicle proteins potentially associated with ACS were identified with differential Q-proteomics and were evaluated in 471 frozen serum samples of ACS-suspected patients presenting to the emergency department (30% of whom had an ACS). Protein levels were measured after vesicle isolation using ExoQuick. Mean serum extracellular vesicle concentration of the different proteins was compared between ACS and non-ACS patients. Selected proteins were tested in a univariate logistic regression model, as well as in a multivariate model to adjust for cardiovascular risk factors. A separate analysis was performed in men and women. In the multivariate logistic regression analysis, polygenic immunoglobulin receptor, (pIgR; OR 1.630, p=0.026), cystatin C (OR 1.641, p=0.021), and complement factor C5a (C5a, OR 1.495, p=0.025) were significantly associated with ACS, while total vesicle protein concentration was borderline significant. The association of the individual proteins with ACS was markedly stronger in men. Conclusions: These data show that serum extracellular vesicle pIgR, cystatin C, and C5a concentrations are independently associated with ACS and that there are pronounced gender differences. These observations should be validated in a large, prospective study to assess the potential role of vesicle content in the evaluation of patients suspected of having an ACS.

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Cystatin C as a predictor of all-cause mortality and myocardial infarction in patients with non-ST-elevation acute coronary syndrome

Cited by 34 publications

References 35 publications

May cystatin-c be associated with post-myocardial infarction complications?

May cystatin-c be associated with post-myocardial infarction complications?

Incremental Prognostic Value of Biomarkers beyond the GRACE (Global Registry of Acute Coronary Events) Score and High-Sensitivity Cardiac Troponin T in Non-ST-Elevation Acute Coronary Syndrome

Serum extracellular vesicle protein levels are associated with acute coronary syndrome

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