Predictive value of circulating cystatin C level in patients with acute coronary syndrome: a meta-analysis

作者：Song Jin, Jian Xu, Gan Shen, Pengying Gu · 发表于：Scandinavian Journal of Clinical and Laboratory Investigation · 年份：2020 · DOI：10.1080/00365513.2020.1846212 · 被引用次数：7 · 研究领域：Chronic Kidney Disease and Diabetes、Retinal Imaging and Analysis、Acute Ischemic Stroke Management

Circulating cystatin C level has been identified as a predictor of adverse outcomes in patients with coronary artery disease (CAD). This meta-analysis aimed to investigate the value of circulating cystatin C level for predicting adverse outcomes in patients with acute coronary syndrome (ACS). We comprehensively searched articles indexed in Pubmed and Embase databases from their inceptions to 30 November 2019. All available observational studies that investigated the association between circulating cystatin C level and major adverse cardiovascular events [MACE] (including death, heart failure, re-infarction, target vascular revascularization, angina and stroke) or all-cause mortality in patients with ACS were included. The prognostic value was expressed by pooling the multivariable-adjusted hazard risk (HR) with 95% confidence interval (CI) for the highest versus the lowest category of cystatin C level. Eleven eligible studies (12 articles) with 4600 ACS patients were identified. Meta-analysis indicated that the highest versus lowest category of cystatin C level was associated with higher risk of MACE (HR 2.28; 95% CI 1.92–2.71) and all-cause mortality (HR 2.89; 95% CI 1.43–5.83) after adjustment for estimated glomerular filtration rate (eGFR) or creatinine. Subgroup analysis by subtypes of patients, study design, follow-up duration and cutoff level of cystatin C further confirmed the value of cystatin C level for predicting MACE. Elevated circulating cystatin C level at basel...