Long-term prognostic impact of cystatin c on acute coronary syndrome octogenarians with diabetes mellitus

Cardiovascular Diabetology

Original Investigation

Zhenhong Fu¹  Wei Dong¹  Hongbin Liu¹  Zhijun Sun¹  Jun Guo¹  Yundai Chen¹  Hao Xue¹  Luyue Gai¹  Lian Chen¹ 

[1] Department of Cardiology, Chinese People’s Liberation Army General Hospital, 28 Fuxing Road, 100853, Beijing, Haidian District, People’s Republic of China;

关键词: Acute coronary syndrome;    Cystatin C;    Octogenarian;    Diabetes mellitus;    Prognosis;   

DOI  :  10.1186/1475-2840-12-157

 received in 2013-10-18, accepted in 2013-10-20,  发布年份 2013

来源: Springer

【 摘 要 】

ObjectiveCystatin C (Cys C) is a marker of renal dysfunction. Prior studies have shown that blood Cys C is related to the prognosis of coronary heart disease. The aim of the present study was to evaluate the long-term prognostic impact of Cys C on acute coronary syndrome (ACS) octogenarians with diabetes mellitus (DM).MethodsWe enrolled 660 consecutive ACS octogenarians who underwent coronary angiography and were classified into two groups based on diabetes. The baseline characters and Cys C level were measured on admission. Survival curve was calculated using the Kaplan-Meier method. Multivariate Cox regression was used to identify predictors of mortality and of major adverse cardiac events (MACE) rate.ResultsThere were 223 and 398 patients in groups DM and non-DM who fulfilled the follow-up. The average follow-up period was 28 (IQR 16–38) months. Diastolic blood pressure (DBP) was lower, ratios of hypertension and chronic renal failure (CRF), fasting blood glucose, HbA1c and Cys C levels were higher in DM group than those in non-DM group (P<0.01). The cumulative survival of DM group was significantly lower than that of non-DM group in the long term (P = 0.018). All cause mortality and MACE of DM group were higher than those of non-DM group (P<0.05). The plasma Cys C concentration (OR = 3.32, 95% CI = 1.18-10.92, P = 0.023) was the uniqueness independent predictor for long-term all cause mortality. The plasma Cys C concentration (OR = 2.47, 95% CI = 1.07-7.86, P = 0.029) and Genesis score (OR = 1.01, 95% CI = 1.00-1.03, P = 0.043) were independent predictors for MACE in DM group. ROC curve analysis showed that the predictive cut-off value of Cys C for mortality of DM group was 1.605 (0.718, 0.704).ConclusionsCys C is an independent predictor for long-term mortality and MACE of ACS octogenarians with DM.

【 授权许可】

Unknown   
© Fu et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.