Cystatin C: A prognostic marker after myocardial infarction in patients without chronic kidney disease

Aims: cystatin c is an endogenous marker of renal function. it is a well established better marker of glomerular filtration rate than serum creatinine. there is also evidence that cystatin c is associated with atherosclerotic disease. the present prospective study evaluated the prognostic value of cystatin c after myocardial infarction in patients without chronic kidney disease. methods and results: a total of 127 patients who underwent coronary angiography after an acute coronary syndrome (acs) were included. cystatin c was associated with the severity of coronary artery disease (cad). cystatin c levels were significantly higher in patients with 3-vessels disease and severe cad according to gensini score (p = 0.01 and p < 0.001 respectively). among the patients admitted for st elevation myocardial infarction,cystatin c concentration was correlated with the initial timi flow in the culprit artery (p < 0.001). mean duration of the follow-up period was 10.76 ± 2.1 months. high cystatin c concentrations were associated to the occurrence of unfavourable outcomes and cardiovascular mortality during follow-up (1.19 ± 0.4 vs. 1.01 ± 0.35 mg/l,p = 0.01 and 1.21 ± 0.36 vs. 0.96 ± 0.27 mg/l,p = 0.03). among different laboratory parameters,cystatin c was the best marker to predict the occurrence of major adverse cardiovascular events during the follow-up (area under the receiveroperating characteristic curve = 0.743). conclusion: high cystatin c levels are associated with the severity of coronary artery disease in patients presenting an acute coronary syndrome and a normal renal function. cystatin c is also associated to unfavourable cardiovascular outcomes during follow-up and appears as a strong predictor for risk of cardiovascular events and death. © 2015 the authors.