title: The association between elevated cystatin C levels with myocardial infarction: a meta-analysis.
abstract: OBJECTIVE
  Cystatin C is a well established marker of kidney function. There is evidence that cystatin C concentrations are also associated with myocardial infarction. The purpose of the present study is to clarify the link between cystatin C with myocardial infarction using a meta-analysis approach.
  
  
  METHODS
  We searched articles indexed in the Pubmed and Sciencedirect published as of August 2015 that met our predefined criteria. A meta-analysis was used to pool estimates of the multivariate adjusted relative risk (RR) with 95% confidence interval (CI), of the association between cystatin C and subsequent risk of myocardial infarction.
  
  
  RESULTS
  Four eligible articles with 10491 subjects from 5 cohort studies were considered in the analysis. Overall, the random-effects meta-analysis results indicated that the highest cystatin C category versus lowest was associated with greater risk of myocardial infarction (RR, 1.78; 95% CI, 1.27 to 2.49; P=0.001). No evidence of publication bias was observed.
  
  
  CONCLUSIONS
  This meta-analysis showed that cystatin C is strongly and independently associated with subsequent risk of myocardial infarction. Further investigation is warranted to clarify whether measurement of cystatin C can usefully reduce the myocardial infarction beyond established predictors already in clinical use.
authors.affiliation: Xiamen Hospital of Traditional Chinese Medicine Xiamen 361009, China.
authors.forename: Minghui
authors.initials: M
authors.lastname: Bi
authors.affiliation: Xiamen Hospital of Traditional Chinese Medicine Xiamen 361009, China.
authors.forename: Zhuo
authors.initials: Z
authors.lastname: Huang
authors.affiliation: The Fifth Affiliated Hospital of Sun Yat-sen University Zhuhai 519000, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Li
authors.affiliation: Southern Medical University Guangzhou 510515, China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Cheng
authors.affiliation: The Affiliated Hospital at Shunde, Southern Medical University Foshan 528300, China.
authors.forename: Yuli
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Xiamen Cardiovascular Hospital Xiamen 361000, China.
authors.forename: Weibing
authors.initials: W
authors.lastname: Chen
keywords: Cystatin C; meta-analysis; myocardial infarction; risk factor