CysC as a predictor of left ventricular remodeling and major adverse cardiovascular events in patients with acute myocardial infarction

Background Percutaneous coronary intervention (PCI) is the primary revascularization method for acute myocardial infarction (AMI); however, patients remain at significant risk of developing left ventricular remodeling (LVR), which is closely associated with major adverse cardiovascular events (MACE). This study evaluated cystatin C (CysC) as a potential biomarker for LVR and MACE after PCI in AMI patients. Methods A total of 168 AMI patients who underwent PCI were followed for 6 months. Transthoracic echocardiography was performed at admission and 6-month follow-up. The endpoints were LVR and MACE. Multivariable logistic regression analysis was used to identify factors associated with LVR, while Cox proportional hazards regression was employed for time-to-MACE analysis. Variables with P < 0.1 in univariate analyses were included in multivariate models. Stepwise forward selection was applied to construct the final models, with adjustment for potential confounders. Results 22% of patients developed LVR and 18.6% experienced MACE. Multivariate regression analysis identified CysC as independently associated with both LVR and MACE after PCI. The AUC for CysC in predicting LVR and MACE was 0.757 and 0.707, respectively. Adding CysC to conventional risk prediction models improved their discriminatory accuracy. Internal validation using bootstrap sampling (1,000 replications) confirmed model reliability. Kaplan–Meier analysis stratified by CysC tertiles demonstrated a significant association between increasing CysC levels and higher incidence of MACE (log-rank P = 0.002). Conclusion CysC was independently associated with LVR and MACE after PCI in patients with AMI, highlighting its potential value as a biomarker for early identification of high-risk patients and guiding targeted therapeutic interventions.