title: Predictive value of elevated cystatin C in patients undergoing primary angioplasty for ST-elevation myocardial infarction.
abstract: OBJECTIVE
  The prognostic value of cystatin C (CysC) has been documented in patients with acute coronary syndrome without ST-segment elevation. However, its value in acute ST-segment elevation myocardial infarction (STEMI) remains unclear. The aim of this study was to evaluate the prognostic value of CysC in patients with STEMI undergoing primary percutaneous coronary intervention (PCI).
  
  
  METHODS
  We prospectively enrolled 475 consecutive STEMI patients (mean age 55.6±12.4 years, 380 male, 95 female) undergoing primary PCI. The study population was divided into tertiles based on admission CysC values. The high CysC group (n=159) was defined as a value in the third tertile (>1.12 mg/L), and the low CysC group (n=316) included those patients with a value in the lower two tertiles (≤1.12 mg/L). Clinical characteristics and in-hospital and one-month outcomes of primary PCI were analyzed.
  
  
  RESULTS
  The patients of the high CysC group were older (mean age 62.8±13.1 vs. 52.3±10.5, P<.001). Higher in-hospital and 1-month cardiovascular mortality rates were observed in the high CysC group (9.4% vs. 1.6%, P<.001 and 14.5% vs. 2.2%, P<.001, respectively). In Cox multivariate analysis; a high admission CysC value (>1.12 mg/L) was found to be a powerful independent predictor of one-month cardiovascular mortality (odds ratio, 5.3; 95% confidence interval, 1.25-22.38; P=.02).
  
  
  CONCLUSIONS
  These results suggest that a high admission CysC level was associated with increased in-hospital and one-month cardiovascular mortality in patients with STEMI undergoing primary PCI.
authors.affiliation: Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey 34303. Electronic address: droakgul@yahoo.com.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Akgul
authors.forename: Huseyin
authors.initials: H
authors.lastname: Uyarel
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ergelen
authors.forename: Hamdi
authors.initials: H
authors.lastname: Pusuroglu
authors.forename: Mehmet
authors.initials: M
authors.lastname: Gul
authors.forename: Selahattin
authors.initials: S
authors.lastname: Turen
authors.forename: Umit
authors.initials: U
authors.lastname: Bulut
authors.forename: Omer Faruk
authors.initials: OF
authors.lastname: Baycan
authors.forename: Ender
authors.initials: E
authors.lastname: Ozal
authors.forename: Mustafa
authors.initials: M
authors.lastname: Cetin
authors.forename: Aydın
authors.initials: A
authors.lastname: Yıldırım
authors.forename: Nevzat
authors.initials: N
authors.lastname: Uslu
mesh_terms: D015415:Biomarkers / Q000097:blood; D055316:Cystatin C / Q000097:blood*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000401:mortality / Q000628:therapy*; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D055316:Cystatin C
keywords: Cystatin C; Primary angioplasty; ST elevation myocardial infarction