Long-term prognostic impact of cystatin c on acute coronary syndrome octogenarians with diabetes mellitus

Fu, Zhenhong; Xue, Hao; Guo, Jun; Chen, Lian; Dong, Wei; Li, Gai; Liu, Hongbin; Sun, Zhijun; Chen, Yundai

doi:10.1186/1475-2840-12-157

Cited by 18 publications

(16 citation statements)

References 34 publications

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“…Increased levels of cystatin C, a cysteine protease, are observed in obese subjects and associate with CVD [19,20]. Serpin G1, better known as C1 inhibitor, is an inhibitor of kallikrein and factor IIa [21].…”

Section: Introductionmentioning

confidence: 99%

Extracellular vesicle markers in relation to obesity and metabolic complications in patients with manifest cardiovascular disease

Kranendonk

Kleijn

Kalkhoven³

et al. 2014

Cardiovasc Diabetol

107

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BackgroundAlterations in extracellular vesicles (EVs), including exosomes and microparticles, contribute to cardiovascular disease. We hypothesized that obesity could favour enhanced release of EVs from adipose tissue, and thereby contribute to cardiovascular risk via obesity-induced metabolic complications. The objectives of this study were: 1) to investigate the relation between the quantity, distribution and (dys) function of adipose tissue and plasma concentrations of atherothrombotic EV-markers; 2) to determine the relation between these EV-markers and the prevalence of the metabolic syndrome; and 3) to assess the contribution of EV markers to the risk of incident type 2 diabetes.MethodsIn 1012 patients with clinically manifest vascular disease, subcutaneous and visceral fat thickness was measured ultrasonographically. Plasma EVs were isolated and levels of cystatin C, serpin G1, serpin F2 and CD14 were measured, as well as fasting metabolic parameters, hsCRP and adiponectin. The association between adiposity, EV-markers, and metabolic syndrome was tested by multivariable linear and logistic regression analyses. As sex influences body fat distribution, sex-stratified analyses between adipose tissue distribution and EV-markers were performed. The relation between EV-markers and type 2 diabetes was assessed with Cox regression analyses.ResultsHigher levels of hsCRP (β 5.59; 95% CI 3.00–8.18) and lower HDL-cholesterol levels (β-11.26; 95% CI −18.39 – -4.13) were related to increased EV-cystatin C levels, and EV-cystatin C levels were associated with a 57% higher odds of having the metabolic syndrome (OR 1.57; 95% CI 1.19–2.27). HDL-cholesterol levels were positively related to EV-CD14 levels (β 5.04; 95% CI 0.07–10.0), and EV-CD14 levels were associated with a relative risk reduction of 16% for development of type 2 diabetes (HR 0.84, 95% CI 0.75–0.94), during a median follow up of 6.5 years in which 42 patients developed type 2 diabetes.ConclusionsIn patients with clinically manifest vascular disease, EV-cystatin C levels were positively related, and EV-CD14 levels were negatively related to metabolic complications of obesity.

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Section: Introductionmentioning

confidence: 99%

Extracellular vesicle markers in relation to obesity and metabolic complications in patients with manifest cardiovascular disease

Kranendonk

Kleijn

Kalkhoven³

et al. 2014

Cardiovasc Diabetol

107

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“…However, in some studies, the frequency of DM was similar in both groups [20]. In one study, 660 very elderly patients (>80 years) undergoing coronary angiography for acute coronary syndrome were investigated to detect the prognostic impact of cystatin C [23].…”

Section: Discussionmentioning

confidence: 99%

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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“…2 National Clinical Research Center of Geriatrics Disease, Beijing, China. 3 the first medical center, Chinese PLA General Hospital, Beijing, China. 4 Department of Cardiology, Hainan Hospital, Chinese PLA General Hospital, Sanya, China.…”

Section: Authors' Contributionsmentioning

confidence: 99%

“…Old age and DM are both independent risk factors for ACS. It is reported that about 75% of patients hospitalized for CHD are associated with abnormal glucose metabolism, and the degree of coronary artery lesions is relatively severe [3,4]. Persistent hyperglycemia in patients results in disorders of platelet structure and function, enhances aggregation and adhesion of platelets, and increases the risk of thrombosis [5].…”

Section: Introductionmentioning

confidence: 99%

Evaluation on Prognostic Ability of Serum Uric Acid for Very Old Acute Coronary Syndrome Patients with Diabetes Mellitus: A Prospective Cohort Study

Yang

Wang

et al. 2020

Preprint

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Background This study sought to evaluate the prognostic power of serum uric acid (UA) in predicting adverse events of very old acute coronary syndrome (ACS) patients with diabetes mellitus (DM).Methods This analysis involved 718 ACS patients > 80 years old who were collected general clinical data and baseline blood biochemical indicators prospectively from January 2006 to December 2012, and these patients were classified into two groups based on DM, then followed up after discharge. Kaplan–Meier method was performed for major adverse cardiac events (MACE) rates and all-cause mortality. Multivariate Cox regression was performed to analyze the relationship between UA level and long-term clinical prognosis. Receiver operating characteristic (ROC) curve was analyzed to predict the cutoff value of UA of the very old ACS patients with DM.Results There were 242 and 476 patients in groups DM and non-DM(NDM) and the follow-up time after discharge was 40–120 months (median: 63 months; interquartile range: 51–74 months). The differences in all-cause mortality, cardiac mortality and MACE rates in DM and NDM patients between the control group were statistically significant (P = 0.001). All-cause mortality, cardiac mortality and MACE incidence in DM patients with moderate and high UA level were significantly higher than those in control group (P = 0.001). There were statistically significant differences in long-term survival rates among the ACS groups (P = 0.001), and long-term survival rates decreased significantly with the increase of UA level. UA (OR = 2.106, 95%CI = 1.244–3.568, P = 0.006) was found to be an independent risk factor for all-cause mortality and MACE in very old ACS patients with DM. The cutoff value of UA was 353.6 µmol/L (sensitivity: 67.4%; specificity: 65.7%). The elevation of serum UA level play an important role in predicting the development of all-cause mortality in elderly ACS patients with DM.Conclusion Serum UA level is a strong independent predictor of long-term all-cause death and MACE in very old ACS patients with DM.

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Long-term prognostic impact of cystatin c on acute coronary syndrome octogenarians with diabetes mellitus

Cited by 18 publications

References 34 publications

Extracellular vesicle markers in relation to obesity and metabolic complications in patients with manifest cardiovascular disease

Extracellular vesicle markers in relation to obesity and metabolic complications in patients with manifest cardiovascular disease

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

Evaluation on Prognostic Ability of Serum Uric Acid for Very Old Acute Coronary Syndrome Patients with Diabetes Mellitus: A Prospective Cohort Study

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