title: [Cystatin C and bleedings during hospitalization of noninvasively treated patients with acute coronary syndromes].
abstract: OBJECTIVE
  To assess relationship between blood level of a marker of renal function cystatin C (CC) and bleeding events in patients with acute coronary syndromes (ACS).
  
  
  METHODS
  CC level was measured in 160 patients from the ACS registry conducted in a noninvasive hospital in Moscow. Each month we included in this registry 25 consecutively hospitalized patients and recorded deaths and bleeding events (major and moderate by TIMI and/or GUSTO criteria) during hospitalization. CC measurement was made by ELISA in stored blood samples taken within first 24 hours after admission. The cut-off level for CC (> 1.53 mg/l) was established by ROC analysis.
  
  
  RESULTS
  There were 10 deaths (6.3%) and 11 bleeding events (6.9%) during hospitalization (median 20 days). Inhospital mortality was 45.5 and 3.4% % among patients with and without bleeding, respectively (=0.0001). Bleeding events occurred significantly more often among patients with CC level >1.53 mg/l compared to those with CC level less or equal 1.53 mg/l (13.8 and 2.1%; respectively, p=0.008). Multifactorial regression analysis identified the following independents predictors of bleeding: thrombolysis at admission (odds ratio [OR] 9.32; 95% confidence interval [95%CI] 1.96-44.29; =0.005), CC level >1.53 mg/l (OR 7.96; 95% CI 1.34-47.26; p=0.023), initial white blood cells count (OR 1.31; 95%CI 1.10-1.57; =0.003). When CC was excluded from regression analysis creatinine clearance entered the list of independent predictors of bleeding (OR 0.95; 95% CI 0.90-0.99; =0.023).
  
  
  CONCLUSIONS
  In this group of noninvasively treated patients with ACS high CC level (>1.53 mg/l) was independently related to major and moderate bleedings during hospitalization. If CC was excluded from analysis, another marker of renal function (creatinine clearance) became an independent predictor of inhospital bleeding.
authors: M S
authors: MS
authors: Kharchenko
authors: A D
authors: AD
authors: Erlikh
authors: E I
authors: EI
authors: Kosenkov
authors: V P
authors: VP
authors: Masenko
authors: N A
authors: NA
authors: Gratsianskiĭ
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000453:epidemiology* / Q000628:therapy; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015984:Causality; D015897:Comorbidity; D003404:Creatinine / Q000097:blood*; D055316:Cystatin C / Q000097:blood*; D005260:Female; D006470:Hemorrhage / Q000097:blood* / Q000401:mortality* / Q000503:physiopathology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D007677:Kidney Function Tests; D008297:Male; D009203:Myocardial Infarction / Q000188:drug therapy / Q000453:epidemiology; D012372:ROC Curve; D012042:Registries; D012426:Russia / Q000453:epidemiology; D015996:Survival Rate
chemical_list: D015415:Biomarkers; D055316:Cystatin C; D003404:Creatinine