Zhibin Xiao, Aoge Riletu, Xiaoyu Yan, Qi Meng, Weiru Zhang, Na Zhang, Chi Ma, Xin Guo, Jiatong Han, Huijuan Nie, Hui Deng, Jing Liu, Jianping Chen, Yu Dong, Tianlong Liu
{"title":"经皮冠状动脉介入治疗患者血清胱抑素 C 水平与主要不良心血管事件的关系。","authors":"Zhibin Xiao, Aoge Riletu, Xiaoyu Yan, Qi Meng, Weiru Zhang, Na Zhang, Chi Ma, Xin Guo, Jiatong Han, Huijuan Nie, Hui Deng, Jing Liu, Jianping Chen, Yu Dong, Tianlong Liu","doi":"10.21037/cdt-23-482","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Recurrent acute myocardial infarction requiring unplanned percutaneous coronary intervention (PCI) is one of the major adverse cardiovascular events (MACEs) in patients with acute coronary syndrome (ACS) after PCI. There is a continuing controversy about the association between serum cystatin C, a biomarker for the evaluation of renal function, and the prognosis of ACS patients following PCI. The retrospective study evaluated the association between serum cystatin C level and MACE in ACS patients after PCI.</p><p><strong>Methods: </strong>Data were retrieved for 330 patients with ACS for primary PCI in a single center. Serum cystatin C levels were measured before PCI. All patients underwent regular follow-ups after PCI, and the studied endpoint was MACE, defined as the need for a repeat revascularization in the heart. The predictive value of serum cystatin C for MACE was analyzed using univariate and multivariate analysis. Restricted cubic spline (RCS) analysis was applied to evaluate the dose-response relationship between serum cystatin C level and MACE in ACS patients following PCI.</p><p><strong>Results: </strong>After a median follow-up of 63 months (range, 1-148 months), 121 of the 330 patients experienced MACE. Compared to patients who did not have MACE, patients who had MACE showed a significant decrease in serum cystatin C levels (0.99±0.32 <i>vs.</i> 1.15±0.78 mg/L, P=0.03). In multivariate regression analysis, serum cystatin C level was an independent risk factor for MACE. According to the serum cystatin C level, patients were divided into 4 categories, Cox regression analysis illustrated that the second quartile of serum cystatin C level indicated an increased risk of MACE in patients with PCI for primary ACS compared to the highest quartile [Q2: adjusted hazard ratio (HR) =2.109; 95% confidence interval (CI): 1.193-3.727; P=0.01]. RCS analysis showed a significant U-shaped dose-response relationship between cystatin C level and MACE in patients with PCI for ACS (P for non-linearity =0.004).</p><p><strong>Conclusions: </strong>These results indicated an association between serum cystatin C level and post-PCI MACE in ACS patients.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"14 4","pages":"621-629"},"PeriodicalIF":2.1000,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384458/pdf/","citationCount":"0","resultStr":"{\"title\":\"Association of serum cystatin C level and major adverse cardiovascular events in patients with percutaneous coronary intervention.\",\"authors\":\"Zhibin Xiao, Aoge Riletu, Xiaoyu Yan, Qi Meng, Weiru Zhang, Na Zhang, Chi Ma, Xin Guo, Jiatong Han, Huijuan Nie, Hui Deng, Jing Liu, Jianping Chen, Yu Dong, Tianlong Liu\",\"doi\":\"10.21037/cdt-23-482\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Recurrent acute myocardial infarction requiring unplanned percutaneous coronary intervention (PCI) is one of the major adverse cardiovascular events (MACEs) in patients with acute coronary syndrome (ACS) after PCI. There is a continuing controversy about the association between serum cystatin C, a biomarker for the evaluation of renal function, and the prognosis of ACS patients following PCI. The retrospective study evaluated the association between serum cystatin C level and MACE in ACS patients after PCI.</p><p><strong>Methods: </strong>Data were retrieved for 330 patients with ACS for primary PCI in a single center. Serum cystatin C levels were measured before PCI. All patients underwent regular follow-ups after PCI, and the studied endpoint was MACE, defined as the need for a repeat revascularization in the heart. The predictive value of serum cystatin C for MACE was analyzed using univariate and multivariate analysis. 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RCS analysis showed a significant U-shaped dose-response relationship between cystatin C level and MACE in patients with PCI for ACS (P for non-linearity =0.004).</p><p><strong>Conclusions: </strong>These results indicated an association between serum cystatin C level and post-PCI MACE in ACS patients.</p>\",\"PeriodicalId\":9592,\"journal\":{\"name\":\"Cardiovascular diagnosis and therapy\",\"volume\":\"14 4\",\"pages\":\"621-629\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2024-08-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384458/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cardiovascular diagnosis and therapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.21037/cdt-23-482\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/8/16 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cardiovascular diagnosis and therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21037/cdt-23-482","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/16 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
背景：急性冠状动脉综合征（ACS）患者在接受经皮冠状动脉介入治疗（PCI）后复发急性心肌梗死，需要进行计划外的经皮冠状动脉介入治疗，这是急性冠状动脉综合征患者的主要心血管不良事件（MACE）之一。血清胱抑素 C 是评估肾功能的生物标志物，它与 PCI 后急性冠状动脉综合征患者的预后之间的关系一直存在争议。这项回顾性研究评估了PCI术后ACS患者血清胱抑素C水平与MACE之间的关系：方法：在一个中心检索了330名接受初级PCI治疗的ACS患者的数据。PCI前测定血清胱抑素C水平。所有患者在PCI术后都接受了定期随访，研究终点为MACE，即需要再次进行心脏血管重建。采用单变量和多变量分析方法分析了血清胱抑素 C 对 MACE 的预测价值。限制立方样条曲线（RCS）分析用于评估PCI术后ACS患者血清胱抑素C水平与MACE之间的剂量-反应关系：中位随访 63 个月（1-148 个月）后，330 例患者中有 121 例发生了 MACE。与未发生 MACE 的患者相比，发生 MACE 的患者血清胱抑素 C 水平显著下降（0.99±0.32 vs. 1.15±0.78 mg/L，P=0.03）。在多变量回归分析中，血清胱抑素 C 水平是 MACE 的独立危险因素。根据血清胱抑素 C 水平，患者被分为 4 类，Cox 回归分析表明，与最高四分位数相比，血清胱抑素 C 水平的第二四分位数表明，PCI 治疗原发性 ACS 患者的 MACE 风险增加[Q2：调整后危险比（HR）=2.109；95% 置信区间（CI）：1.193-3.727；P=0.01]。RCS分析显示，胱抑素C水平与ACS PCI患者的MACE之间存在明显的U形剂量反应关系（非线性P=0.004）：这些结果表明，ACS 患者血清胱抑素 C 水平与 PCI 术后 MACE 存在关联。
Association of serum cystatin C level and major adverse cardiovascular events in patients with percutaneous coronary intervention.
Background: Recurrent acute myocardial infarction requiring unplanned percutaneous coronary intervention (PCI) is one of the major adverse cardiovascular events (MACEs) in patients with acute coronary syndrome (ACS) after PCI. There is a continuing controversy about the association between serum cystatin C, a biomarker for the evaluation of renal function, and the prognosis of ACS patients following PCI. The retrospective study evaluated the association between serum cystatin C level and MACE in ACS patients after PCI.
Methods: Data were retrieved for 330 patients with ACS for primary PCI in a single center. Serum cystatin C levels were measured before PCI. All patients underwent regular follow-ups after PCI, and the studied endpoint was MACE, defined as the need for a repeat revascularization in the heart. The predictive value of serum cystatin C for MACE was analyzed using univariate and multivariate analysis. Restricted cubic spline (RCS) analysis was applied to evaluate the dose-response relationship between serum cystatin C level and MACE in ACS patients following PCI.
Results: After a median follow-up of 63 months (range, 1-148 months), 121 of the 330 patients experienced MACE. Compared to patients who did not have MACE, patients who had MACE showed a significant decrease in serum cystatin C levels (0.99±0.32 vs. 1.15±0.78 mg/L, P=0.03). In multivariate regression analysis, serum cystatin C level was an independent risk factor for MACE. According to the serum cystatin C level, patients were divided into 4 categories, Cox regression analysis illustrated that the second quartile of serum cystatin C level indicated an increased risk of MACE in patients with PCI for primary ACS compared to the highest quartile [Q2: adjusted hazard ratio (HR) =2.109; 95% confidence interval (CI): 1.193-3.727; P=0.01]. RCS analysis showed a significant U-shaped dose-response relationship between cystatin C level and MACE in patients with PCI for ACS (P for non-linearity =0.004).
Conclusions: These results indicated an association between serum cystatin C level and post-PCI MACE in ACS patients.
期刊介绍：
The journal ''Cardiovascular Diagnosis and Therapy'' (Print ISSN: 2223-3652; Online ISSN: 2223-3660) accepts basic and clinical science submissions related to Cardiovascular Medicine and Surgery. The mission of the journal is the rapid exchange of scientific information between clinicians and scientists worldwide. To reach this goal, the journal will focus on novel media, using a web-based, digital format in addition to traditional print-version. This includes on-line submission, review, publication, and distribution. The digital format will also allow submission of extensive supporting visual material, both images and video. The website www.thecdt.org will serve as the central hub and also allow posting of comments and on-line discussion. The web-site of the journal will be linked to a number of international web-sites (e.g. www.dxy.cn), which will significantly expand the distribution of its contents.
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