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Association of Cystatin C with Metabolic Syndrome and Its Prognostic Performance in Non-ST-Segment Elevation Acute Coronary Syndrome with Preserved Renal Function.
- Source :
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BioMed research international [Biomed Res Int] 2019 Jun 16; Vol. 2019, pp. 8541402. Date of Electronic Publication: 2019 Jun 16 (Print Publication: 2019). - Publication Year :
- 2019
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Abstract
- 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.<br />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.<br />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).<br />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.
- Subjects :
- Acute Coronary Syndrome blood
Acute Coronary Syndrome complications
Acute Coronary Syndrome physiopathology
Aged
Biomarkers blood
Electrocardiography
Female
Heart Failure complications
Heart Failure physiopathology
Humans
Kidney metabolism
Kidney physiology
Male
Metabolic Syndrome complications
Metabolic Syndrome physiopathology
Middle Aged
Non-ST Elevated Myocardial Infarction complications
Non-ST Elevated Myocardial Infarction physiopathology
Prognosis
ROC Curve
Risk Factors
Stroke blood
Stroke complications
Stroke physiopathology
Cystatin C blood
Heart Failure blood
Metabolic Syndrome blood
Non-ST Elevated Myocardial Infarction blood
Subjects
Details
- Language :
- English
- ISSN :
- 2314-6141
- Volume :
- 2019
- Database :
- MEDLINE
- Journal :
- BioMed research international
- Publication Type :
- Academic Journal
- Accession number :
- 31317040
- Full Text :
- https://doi.org/10.1155/2019/8541402