Key result
High cystatin C linked to ~161% greater 12-month major cardiovascular events risk in NSTE-ACS patients.
Why the study?
The underlying mechanisms by which cystatin C affects cardiovascular disease are not clear, prompting investigation into its association with metabolic syndrome and cardiovascular outcomes in NSTE-ACS patients with preserved renal function.
Is cystatin C level associated with metabolic syndrome and 12-month MACEs in patients with NSTE-ACS and preserved renal function?
Cohort (n=422)
No
Is cystatin C level associated with metabolic syndrome and 12-month MACEs in patients with NSTE-ACS and preserved renal function?
Answers are grounded in this paper and cite their sources.
In patients with NSTE-ACS and preserved renal function, elevated cystatin C levels are independently associated with metabolic syndrome and predict 12-month major adverse cardiovascular events.
Objective. The underlying mechanisms by which cystatin C affects cardiovascular disease (CVD) are not very clear. Metabolic syndrome (MetS) is a cluster of risk factors that increase the risk of CVD. Here, we aimed to investigate the association of cystatin C with metabolic syndrome and cardiovascular outcomes in non-ST-segment elevation acute coronary syndrome (NSTE-ACS) with preserved renal function. Methods. In total, 422 NSTE-ACS patients with preserved renal function were enrolled to examine the association of cystatin C with MetS. MetS was defined based on the NCEP-ATP-III guidelines. Major adverse cardiovascular events (MACEs) were also evaluated, which included cardiac death, nonfatal myocardial infarction (MI), target vessel revascularization (TVR), heart failure, and nonfatal stroke. All patients underwent a 12-month follow-up for MACEs after admission. Results. Cystatin C was significantly correlated with metabolic risk factors and inflammation markers. The prevalence of MetS and MACEs correlated with cystatin C levels. Cystatin C showed a strong diagnostic performance for cardiovascular risk factors and outcomes in ROC analysis. After adjustment for multiple risk factors, cystatin C level was independently associated with MetS (OR 2.299, 95% CI 1.251–4.225, and P = 0.007). During a 12-month follow-up, the patients with high cystatin C level and MetS had higher incidence of MACEs (Log-rank = 24.586, P < 0.001) and cardiac death (Log-rank = 9.890, P = 0.020) compared to the others. Multivariate Cox analysis indicated that cystatin C level was an independent predictor of MACEs (HR 2.609, 95% CI 1.295–5.257, and P = 0.007). Conclusion. Cystatin C may be an independent predictor of metabolic syndrome and therefore valuable for management of NSTE-ACS patients. Further multicenter, large-scale studies are required to assess the implication of these results.
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Mao et al. (2019) conducted a cohort in Non-ST-segment elevation acute coronary syndrome (NSTE-ACS) with preserved renal function (n=422). Cystatin C vs. Low cystatin C level was evaluated on Major adverse cardiovascular events (MACEs) (HR 2.609, 95% CI 1.295-5.257, p=0.007). High cystatin C levels independently predicted 12-month major adverse cardiovascular events and metabolic syndrome in NSTE-ACS patients.
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