Document Detail


Plasma cystatin C for prediction of 1-year cardiac events in Mediterranean patients with non-ST elevation acute coronary syndrome.
MedLine Citation:
PMID:  19819453     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Evaluation of renal function (RF) is important for management of patients with non-ST elevation acute coronary syndrome (NSTE-ACS). Cystatin C, a sensitive marker of RF, appears to be also a marker of cardiovascular risk. Little is known regarding its predictive role in NSTE-ACS patients. METHODS: We assessed 525 patients taking part in the "Systemic Inflammation Evaluation in patients with NSTE-ACS" (SIESTA) study. Patients were subdivided in quartiles according to cystatin C plasma concentrations (mg/L), i.e., Q1<0.81; Q2=0.81-0.92; Q3=0.93-1.10; Q4>or=1.11. Glomerular filtration rate (eGFR) was estimated using the modification of diet in renal disease (MDRD) equation. The study end-point was the composite of cardiac death, non-fatal myocardial infarction and unstable angina at 1-year follow up. RESULTS: Few patients (0.8%) had severely impaired RF (MDRD<30ml/min/1.73m(2)). 157 patients reached (30%) the study end-point. Patients in Q3 and Q4 showed a higher cumulative probability of cardiac events compared to patients in the lowest quartile. On multivariable analysis, patients in Q3 and Q4 had an increased incidence of cardiac events (adjusted HR=1.57 95%CI 1.04-2.49; p=0.036). Patients with TIMI risk score >or=3 or in-hospital heart failure were also at higher risk for acute cardiac events. Conventional markers of RF, i.e., serum creatinine and eGRF, were not predictors for the study end-point. CONCLUSIONS: Increased levels of cystatin C were an independent predictor of cardiac events at 1-year follow up in this contemporary series of Mediterranean patients with NSTE-ACS.
Authors:
Nevio Taglieri; Daniel J Fernandez-Berges; Wolfgang Koenig; Luciano Consuegra-Sanchez; Jos? Maria Cruz Fernandez; Nicolas Roberto Robles; Pedro Luis S?nchez; Alfonso Castro Beiras; Pedro Maria Montes Orbe; Juan Carlos Kaski;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2009-09-20
Journal Detail:
Title:  Atherosclerosis     Volume:  209     ISSN:  1879-1484     ISO Abbreviation:  Atherosclerosis     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-01     Completed Date:  2010-06-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0242543     Medline TA:  Atherosclerosis     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  300-5     Citation Subset:  IM    
Affiliation:
Cardiovascular Biology Research Centre, Division of Cardiac and Vascular Sciences, St. George's University of London, London, UK.
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / blood,  mortality*
Aged
Angina, Unstable / blood,  mortality*
Cystatin C / blood*
Female
Glomerular Filtration Rate
Humans
Kidney / physiopathology
Male
Mediterranean Region
Middle Aged
Myocardial Infarction / blood,  mortality*
Prognosis
Spain / epidemiology
Chemical
Reg. No./Substance:
0/Cystatin C
Investigator
Investigator/Affiliation:
J M Cruz Fern?ndez / ; V L?pez Garc?a-Aranda / ; R Cabrera / ; R Toro / ; M Sancho Jald?n / ; D Fern?ndez-Berg?s / ; M J Zaro / ; R Alzugaray / ; M Veiga / ; J R Gonz?lez-Juanatey / ; L Grigorian / ; P Bassante / ; L Mart?n Jadraque / ; G Guzm?n Mart?nez / ; C Mart?n Luengo / ; P L S?nchez / ; J L Mori?igo / ; A Castro Beiras / ; I Mosquera / ; P M Montes Orbe / ; I Egu?a Astobiza / ; X Garc?a-Moll / ; M M Mart? / ; V Barriales Alvarez / ; Dae-Hyun Lee Hwang / ; F J Carrasco S?nchez / ; A Tobaruela / ; J M Santos / ; S Delgado / ; C Santos / ; R Arroyo Espliguero / ; J Balaguer / ; P L S?nchez / ; M T Villaroel / ; A Capdevila / ; C Limi?ana / ; J C Castillo Dom?nguez / ; J Sotillo Mart? / ; E Dall? / ; M L Martinez / ; E Castillo Lue?a / ; L L?pez-Besc?s / ; J Jim?nez / ; F Vall?s Belsu? / ; A L?pez Granados / ; J L Diago Torrent / ; G Marcos G?mez / ; F Sogorb Garr? / ; E Pay? Mora / ; Marina Alta / ; A Valls / ; R Mu?oz Aguilera / ; J A Serrano Sanz / ; D Pascual Hern?ndez / ; J A Garc?a Robles / ; M P?rez de Juan Romero / ; C Lahoz / ; R Pe?a /

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