Prognostic Significance of Cystatin C in Patients With ST-Elevation Myocardial Infarction

Ichimoto, Eiji; Jo, Kigen; Kobayashi, Yoshio; Inoue, Toshihisa; Nakamura, Yoshitake; Kuroda, Nakabumi; Miyazaki, Akira; Komuro, Issei

doi:10.1253/circj.cj-08-0943

Cited by 38 publications

(27 citation statements)

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“…Concentrations of cystatin C have been related to both mortality and myocardial infarction rates in a non-STelevation acute coronary syndrome (NSTE-ACS) population (16 ). However, the relation between concentrations of cystatin C and outcomes in a STE-ACS population is unclear (18 ), and the predictive value of CKD-EPI in patients with ACS has not been investigated. The Platelet Inhibition and Patient Outcomes (PLATO) trial (19,20 ) randomized a broad population with ACS, including both NSTE-ACS and STE-ACS, to antiplatelet treatment with ticagrelor vs clopidogrel during 6 -12 months of follow-up.…”

confidence: 99%

Cystatin C and Estimated Glomerular Filtration Rate as Predictors for Adverse Outcome in Patients with ST-Elevation and Non–ST-Elevation Acute Coronary Syndromes: Results from the Platelet Inhibition and Patient Outcomes Study

et al. 2012

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confidence: 99%

Cystatin C and Estimated Glomerular Filtration Rate as Predictors for Adverse Outcome in Patients with ST-Elevation and Non–ST-Elevation Acute Coronary Syndromes: Results from the Platelet Inhibition and Patient Outcomes Study

et al. 2012

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“…8 Recent studies have revealed that CysC has a predictive and prognostic value in cardiovascular disease, especially coronary artery disease and heart failure. [9][10][11][12][13] However, the literature on the role of CysC in subjects with COPD exacerbation is sparse. One study that examined the level of CysC in COPD subjects showed that a high CysC concentration may be a potential indicator of impaired lung function and that routinely measuring CysC may improve the diagnosis and assessment of COPD severity in elderly male subjects.…”

mentioning

confidence: 99%

Cystatin C as a Predictor of In-Hospital Mortality After Exacerbation of COPD

Zhou

et al. 2016

Respir Care

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BACKGROUND: COPD is associated with cardiovascular and renal dysfunction. Cystatin C (CysC) is a biomarker of renal function and an independent risk factor for all-cause and cardiovascular mortality among elderly persons. The aim of the study was to examine the prognostic role of CysC for in-hospital mortality in subjects with a COPD exacerbation. METHODS: Upon admission, serum CysC levels and arterial blood gas analysis from 477 subjects with a COPD exacerbation were measured. Clinical characteristics were also recorded. A receiver operating characteristic curve analysis was used to determine the level of CysC that discriminated survivors from nonsurvivors. Univariate and multiple logistic regression analyses were used to identify the risk factors for in-hospital mortality. To reduce the influence of confounders, subgroup analyses were performed according to the comorbidities, including states of heart failure, renal dysfunction, and pH, P aCO 2 , and P aO 2 levels. RESULTS: During the in-hospital period, 59 subjects died, and 418 subjects recovered. The decedent group showed lower pH (7.27 ؎ 0.17 vs 7.38 ؎ 0.06, P < .001), higher CysC (2.21 ؎ 1.05 mg/L vs 1.39 ؎ 0.54 mg/L, P < .001), higher P aCO 2 (77 ؎ 39 mm Hg vs 48 ؎ 14 mm Hg, P < .001), and lower P aO 2 (74 ؎ 32 mm Hg vs 84 ؎ 26 mm Hg, P < .001) levels. The area under the receiver operating characteristic curve for the CysC prediction of death was 0.77 (95% CI 0.70 -0.84). CysC values >1.59 mg/L were associated with significantly higher inhospital mortality (relative risk ‫؍‬ 5.49, 95% CI 3.24 -9.32, P < .001). Multiple logistic regression analysis showed that pH <7.20, CysC >1.59 mg/L, and heart failure were independent predictors of in-hospital mortality. The subgroup analysis showed that the comorbid states of renal dysfunction, congestive heart failure, and the levels of pH, P aCO 2 , and P aO 2 did not alter the conclusion that CysC was a mortality risk factor for subjects with a COPD exacerbation. CONCLUSION: CysC was a strong and independent risk factor for hospital mortality secondary to COPD exacerbation.

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“…8,9 Thus, in addition to ACS and CHD, Ichimoto et al have added to the literature on the utility of cystatin C for the prediction of CV events in patients with STEMI. 6 Several issues should be noted to interpret the present findings. The sample size was so small that any negative findings could be caused by a low statistical power.…”

Section: Article P 1669mentioning

confidence: 88%

“…5 In this issue of the Circulation Journal, Ichimoto et al provided evidence for the prognostic value of cystatin C in patients with ST-elevation MI (STEMI). 6 Seventy-one patients with STEMI were divided into 2 groups according to the cystatin C level measured before emergent percutaneous coronary intervention. Although there were no significant differences in baseline characteristics, except for the serum creatinine level between the groups, the group with the higher cystatin C level showed a worse event-free survival during the mean follow up of 5.6 months by KaplanMeier analysis.…”

Section: Article P 1669mentioning

confidence: 99%