Cystatin C as a Predictor of Major Adverse Cardiovascular Event in Patients with Acute Myocardial Infarction Without Cardiogenic Shock and Renal Impairment After Coronary Intervention

Purpose: To prove that cystatin C is a predictor of major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI), either with ST-segment Elevation (AMI-EST) or without ST-segment elevation (AMI-NEST), without cardiogenic shock or renal impairment.

Patient and methods: This was an observational cohort study. Samples were obtained from AMI patients who underwent PCI between February 2022 and March 2022 at the Intensive Cardiovascular Care Unit. Cystatin C levels were measured before PCI. MACE were observed within 6 months. Comparisons between normally distributed continuous data were performed using the t-test; Mann-Whitney test was used for non-normally distributed data. Categorical data were compared using the chi-squared test. The cut-off point of cystatin C levels to predict MACE was analyzed using Receiver Operating Characteristics (ROC).

Results: The participants were 40 AMI patients, consisting of 32 patients (80%) with AMI-EST and eight patients (20%) diagnosed with AMI-NEST, who were evaluated for the occurrence of MACE within 6 months after PCI. Ten patients (25%) developed MACE during follow-up [(MACE (+)], and the rest were in the MACE (-) group. Cystatin C levels were significantly higher in the MACE (+) group (p=0.021). ROC analysis revealed a cystatin C level of 1.21 mg/dL; cystatin C > 1.21 is associated with MACE risk, showing a significant relationship with the odds ratio value reaching 26.00, with 95% CI (3.99-169.24).

Conclusion: Cystatin C level is an independent predictor of MACE in patients with AMI without cardiogenic shock or renal impairment after PCI.