Association of Cystatin C with Metabolic Syndrome and Its Prognostic Performance in Non-ST-Segment Elevation Acute Coronary Syndrome with Preserved Renal Function

الملخص EN

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.