Department of Cardiology, The First Affiliated Hospital and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, 471003, China.
Department of Pain, The First Affiliated Hospital and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, 471003, China.
Atherosclerosis. 2017 Aug;263:60-67. doi: 10.1016/j.atherosclerosis.2017.05.025. Epub 2017 May 22.
Circulating cystatin C has been recognized as an independent predictor of cardiovascular and all-cause mortality in the general population. We aimed to evaluate the prognostic value of baseline circulating cystatin C levels in people with suspected or established coronary artery disease (CAD) by conducting a meta-analysis.
We searched Pubmed and Embase databases up to October 2016 for prospective observational studies investigating the predictive value of elevated circulating cystatin C levels in people with suspected or established CAD. Adverse vascular outcomes included all-cause mortality, cardiovascular mortality, or total adverse vascular events consisting of death, myocardial infarction, revascularization, stroke, and heart failure.
Ten studies involving participants with known or suspected CAD were included in this meta-analysis. When comparing the highest with the lowest cystatin C levels, the pooled hazard ratio (HR) was 2.27 (95% confidence interval [CI] 1.86-2.78) for all-cause mortality, 2.24 (95% CI 1.69-2.97) for cardiovascular mortality, and 1.87 (95% CI 1.57-2.24) for total adverse vascular events, respectively. Subgroup analysis results showed that this association was not influenced by follow-up duration, region, or CAD type.
Elevated circulating cystatin C is independently associated with adverse vascular outcomes in people with suspected or established CAD in terms of all-cause mortality, cardiovascular mortality, and total adverse vascular events. This increased risk is probably independent of creatinine/estimated glomerular filtration rate.
循环胱抑素 C 已被认为是普通人群心血管和全因死亡率的独立预测因子。我们旨在通过荟萃分析评估基线循环胱抑素 C 水平在疑似或确诊冠心病 (CAD) 患者中的预后价值。
我们检索了 Pubmed 和 Embase 数据库，截至 2016 年 10 月，以寻找前瞻性观察性研究，这些研究调查了升高的循环胱抑素 C 水平在疑似或确诊 CAD 患者中的预测价值。不良血管结局包括全因死亡率、心血管死亡率或由死亡、心肌梗死、血运重建、卒中和心力衰竭组成的总不良血管事件。
共有 10 项包含已知或疑似 CAD 患者的研究被纳入本荟萃分析。当比较最高与最低胱抑素 C 水平时，全因死亡率的合并危险比 (HR) 为 2.27（95%置信区间 [CI] 1.86-2.78），心血管死亡率为 2.24（95%CI 1.69-2.97），总不良血管事件为 1.87（95%CI 1.57-2.24）。亚组分析结果表明，这种相关性不受随访时间、地域或 CAD 类型的影响。
在疑似或确诊 CAD 患者中，循环胱抑素 C 水平升高与全因死亡率、心血管死亡率和总不良血管事件的不良血管结局独立相关。这种风险增加可能与肌酐/估计肾小球滤过率无关。
