Association of serum cystatin C levels with myocardial perfusion and cardiac functional recovery in patients with anterior wall ST elevation myocardial infarction treated with primary coronary intervention.
This study sought to investigate the association of baseline serum cystatin C levels with myocardial perfusion and cardiac functional recovery in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). 108 patients with a first anterior STEMI who underwent PPCI were enrolled. Serum cystatin C was measured by immunoturbidimetric method. Patients were divided into two groups according to the median cystatin C levels on admission: group 1 (≥median, n = 54) and group 2 (<median, n = 54). Myocardial perfusion was assessed by angiographic criteria, ST-segment resolution, and the index of microcirculatory resistance (IMR). Echocardiographic wall motion score index was analyzed on admission and at 6-month follow-up. Patients with angiographically, electrocardiographically no-reflow had significantly higher cystatin C levels on admission. Patients with an IMR ≥33.7 U also had significantly higher cystatin C levels. The WMSI showed a greater improvement in group 2 than in group 1 and there was a significant negative correlation between improvement of WMSI and the cystatin C levels. There was no significant difference in MACEs between the 2 groups. However, congestive heart failure (CHF) was observed significantly more frequent in group 1 than in group 2 (18.5 vs. 5.6 %, p = 0.022). Multivariate logistic regression analysis demonstrated that cystatin C levels at admission were a significant independent predictor of angiographic no-reflow and the development of CHF at 6-month follow-up. Elevated cystatin C levels at admission were independently associated with impaired myocardial perfusion, poor cardiac functional recovery and development of CHF in patients with anterior STEMI undergoing PPCI.
Department of Cardiology, The Second Xiangya Hospital of Central South University, No. 139, Middle Ren-min Road, Changsha, 410011, Hunan, China.
Liang
L
Tang
Department of Cardiology, The Second Xiangya Hospital of Central South University, No. 139, Middle Ren-min Road, Changsha, 410011, Hunan, China.
Zhen-Fei
ZF
Fang
Department of Cardiology, The Second Xiangya Hospital of Central South University, No. 139, Middle Ren-min Road, Changsha, 410011, Hunan, China.
Sheng-Hua
SH
Zhou
Department of Cardiology, The Second Xiangya Hospital of Central South University, No. 139, Middle Ren-min Road, Changsha, 410011, Hunan, China.
Shi
S
Tai
Department of Cardiology, The Second Xiangya Hospital of Central South University, No. 139, Middle Ren-min Road, Changsha, 410011, Hunan, China.
Salah
S
Ahmed
Department of Cardiology, The Second Xiangya Hospital of Central South University, No. 139, Middle Ren-min Road, Changsha, 410011, Hunan, China.
Feng
F
Huang
Department of Cardiology, The Second Xiangya Hospital of Central South University, No. 139, Middle Ren-min Road, Changsha, 410011, Hunan, China.
Xiang-Qian
XQ
Shen
Department of Cardiology, The Second Xiangya Hospital of Central South University, No. 139, Middle Ren-min Road, Changsha, 410011, Hunan, China.
Yan-Shu
YS
Zhao
Department of Cardiology, The Second Xiangya Hospital of Central South University, No. 139, Middle Ren-min Road, Changsha, 410011, Hunan, China. professorhuxq@yeah.net.
Xin-Qun
XQ
Hu
D000328:Adult; D000368:Aged; D056988:Anterior Wall Myocardial Infarction / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D003326:Coronary Circulation; D055316:Cystatin C / Q000097:blood*; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods; D054318:No-Reflow Phenomenon / Q000209:etiology / Q000503:physiopathology; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects; D011237:Predictive Value of Tests; D020127:Recovery of Function; D012307:Risk Factors; D000072657:ST Elevation Myocardial Infarction / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation; D016277:Ventricular Function, Left
D015415:Biomarkers; C525030:CST3 protein, human; D055316:Cystatin C
Acute myocardial infarction; Cystatin C; No-reflow; Primary percutaneous coronary intervention