title: Cystatin C as a predictor of all-cause mortality and myocardial infarction in patients with non-ST-elevation acute coronary syndrome.
abstract: OBJECTIVE
  To investigate the predictive value of cystatin C among patients diagnosed with non-ST-elevation acute coronary syndrome (nSTE-ACS).
  
  
  METHODS
  Admission serum samples from 245 nSTE-ACS patients were measured with a novel cystatin C immunoassay based on a dry-reagent, double monoclonal design. Creatinine concentrations, estimated glomerular filtration rates (eGFR) and one-year follow-up data were available for these patients.
  
  
  RESULTS
  During the follow-up period, 34 (14%) of patients had myocardial infarction (MI) and 25 (11%) died. Increased serum cystatin C was an independent predictor of all-cause mortality and combined events (all-cause mortality and MI) after adjustment to non-biomarker baseline factors, hazard ratio (HR) 2.19 (per increase of 1 tertile; 95% Cl 1.28-3.78, p=0.0046) and 1.75 (1.22-2.51, p=0.0024), respectively. Corresponding values for eGFR were 2.56 (1.43-4.59, p=0.0016) and 1.76 (1.23-2.53, p=0.0022), respectively. Creatinine was not an independent predictor of endpoints (p>0.05).
  
  
  CONCLUSIONS
  Cystatin C was associated with an increased risk of death and combined events in patients with nSTE-ACS.
authors.affiliation: Department of Biotechnology, University of Turku, Tykistökatu 6A, 20520 Turku, Finland. noora.ristiniemi@utu.fi
authors.forename: Noora
authors.initials: N
authors.lastname: Ristiniemi
authors.forename: Juha
authors.initials: J
authors.lastname: Lund
authors.forename: Risto
authors.initials: R
authors.lastname: Tertti
authors.forename: Anders
authors.initials: A
authors.lastname: Christensson
authors.forename: Tuomo
authors.initials: T
authors.lastname: Ilva
authors.forename: Pekka
authors.initials: P
authors.lastname: Porela
authors.forename: Kari
authors.initials: K
authors.lastname: Pulkki
authors.forename: Kim
authors.initials: K
authors.lastname: Pettersson
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000401:mortality*; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000378:metabolism; D015415:Biomarkers / Q000097:blood; D003404:Creatinine / Q000097:blood; D055316:Cystatin C / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007118:Immunoassay / Q000379:methods; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000401:mortality*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012372:ROC Curve; D012307:Risk Factors
chemical_list: D000911:Antibodies, Monoclonal; D015415:Biomarkers; D055316:Cystatin C; D003404:Creatinine