Association between cystatin C and major adverse cardiac events in patients with ischemic heart disease and type 2 diabetes mellitus after acute coronary syndrome
DOI:
https://doi.org/10.14739/2310-1210.2019.3.168962Keywords:
myocardial ischemia, type 2 diabetes mellitus, cystatin CAbstract
Purpose. To evaluate the level of cystatin C and its association with the risk of developing repeated major adverse cardiac events (MACE) in patients with ischemic heart disease (IHD) and preserved kidney function in combination with type 2 diabetes mellitus (DM) within 12 months after acute coronary syndrome (ACS).
Materials and methods. A total of 88 patients, aged 30–75 years, (59 patients with DM and 29 patients without DM) with prior ACS (unstable angina or myocardial infarction) in the previous 4–6 weeks were enrolled. The control group consisted of 15 healthy persons. The follow-up period was 11 months.
Results. Cystatin C level in patients with DM was higher than in patients without DM (2057.69 ± 107.56 ng/ml vs 1376.57 ± 81.11 ng/ml, P < 0.05). In patients with CHD without diabetes, the level of cystatin C was although higher than in the control group, but not statistically significantly (P > 0.05).
During the follow-up period, the MACE rate in DM patients was higher than in patients without DM, 40.68 % (n = 24) and 10.34 % (n = 3), respectively, P < 0.05. According to the ROC analysis, cystatin C level of more than 1942.62 ng/ml was associated with MACE occurrence in DM patients within 12 months after ACS, the sensitivity of the method was 82.60 %, specificity – 64.30 %. As a result of the multivariate regression analysis adjusted for age and sex, it has been identified that cystatin C was an independent predictor for MACE occurrence in DM patients within 12 months after ACS (OR 3ю78, 95 % CI [1.51, 7.41], P = 0.001).
Conclusions. Cystatin C was an independent predictor for MACE after ACS in patients with DM and preserved kidney function.
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