Department of Integrated ICU, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, PR China.
Heart Lung. 2012 Sep-Oct;41(5):456-62. doi: 10.1016/j.hrtlng.2012.04.007. Epub 2012 May 30.
This study was designed to evaluate the value of plasma cystatin C in predicting adverse cardiac events after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS).
A total of 605 patients (404 male, mean age 60.4 ± 10.6 years) with ACS underwent successful PCI. Patients were divided into 4 groups according to the level of cystatin C, which was measured before the PCI: Q1 (<1.02 mg/L), Q2 (1.02-1.16 mg/L), Q3 (1.17-1.34 mg/L), and Q4 (≥1.35 mg/L).
After a follow-up of 14.3 ± 1.7 months, the incidence of mortality, nonfatal myocardial infarction, and target lesion revascularization in the Q2, Q3, and Q4 groups was higher than in the Q1 group (P < .001). The incidence of heart failure in the Q3 and Q4 groups was higher than in the Q1 group (P < .05). Multivariate Cox regression analysis showed that cystatin C elevation was an independent predictor of major adverse cardiac events. The cumulative survival rate of the Q3 and Q4 groups was lower than in the Q1 group (P < .001).
High plasma cystatin C concentration is an independent predictor of major adverse cardiac events in patients with ACS treated with PCI.
本研究旨在评估血浆胱抑素 C 在预测急性冠状动脉综合征（ACS）经皮冠状动脉介入治疗（PCI）后不良心脏事件中的价值。
共有 605 例 ACS 患者（404 例男性，平均年龄 60.4±10.6 岁）成功接受了 PCI。根据 PCI 前胱抑素 C 水平，患者分为 4 组：Q1（<1.02mg/L）、Q2（1.02-1.16mg/L）、Q3（1.17-1.34mg/L）和 Q4（≥1.35mg/L）。
随访 14.3±1.7 个月后，Q2、Q3 和 Q4 组的死亡率、非致死性心肌梗死和靶病变血运重建发生率均高于 Q1 组（P<0.001）。Q3 和 Q4 组心力衰竭的发生率高于 Q1 组（P<0.05）。多变量 Cox 回归分析显示，胱抑素 C 升高是主要不良心脏事件的独立预测因子。Q3 和 Q4 组的累积生存率低于 Q1 组（P<0.001）。
高血浆胱抑素 C 浓度是 PCI 治疗的 ACS 患者发生主要不良心脏事件的独立预测因子。
