Studies included only in the systematic review and meta-analysis |
Tonkin et al., 20151515 Tonkin AM, Blankenberg S, Kirby A, Zeller T, Colquhoun DM, Funke-Kaiser A, et al; LIPID study investigators. Biomarkers in stable coronary heart disease, their modulation and cardiovascular risk: The LIPID biomarker study. Int J Cardiol. 2015 Dec 15;201:499-507. doi: 10.1016/j.ijcard.2015.07.080. https://doi.org/10.1016/j.ijcard.2015.07...
|
Unstable angina, NSTEMI, STEMI |
NI |
9014/ 31-75 |
5 years/ Cardiovascular death, non-fatal infarction |
Immunoturbidimetry |
Yes |
GFR = 69 (60-80) |
Akerblom et al., 20121616 Akerblom Å, Wallentin L, Siegbahn A, Becker RC, Budaj A, Buck K, et al. Cystatin C and estimated glomerular filtration rate as predictors for adverse outcome in patients with ST-elevation and non-ST-elevation acute coronary syndromes: results from the Platelet Inhibition and Patient Outcomes study. Clin Chem. 2012;58(1):190-9. doi: 10.1373/clinchem.2011.171520. https://doi.org/10.1373/clinchem.2011.17...
|
NSTEMI, STEMI |
NSTEMI: at least two of these criteria: change in ST segment; increase in cardiac marker levels; presence of one of the risk factors. STEMI: at least two of the following criteria: ST segment elevation in ECG; recent left bundle branch block; intention to perform primary PCI. |
16401/ 57 (51-64) (1st quartile) 59 (52-67) (2nd quartile) 63 (56-71) (3rd quartile) 70 (61-76) (4th quartile) |
12 months/ Cardiovascular death, non-fatal infarction |
Immunoturbidimetry |
No |
GFR = 82,6 |
Studies included only in the systematic review |
Tang et al., 20151717 Tang L, Fang ZF, Zhou SH, Tai S, Ahmed S, Huang F, et al. Association of serum Cystatin C levels with myocardial perfusion and cardiac functional recovery in patients with anterior wall ST elevation myocardial infarction treated with primary coronary intervention. Heart Vessels. 2015.31(9):1456-66. doi: 10.1007/s00380-015-0764-z. https://doi.org/10.1007/s00380-015-0764-...
|
STEMI |
Chest pain > 30 min, ST segment elevation in ECG; recent left bundle branch block; increase in cardiac markers |
108/ 58.8 ± 9.8 (cystatin C < 1.36 mg/L) 65.9 ± 11.3 (cystatin C ≥ 1.36 mg/L) |
6 months/ Cardiovascular death, non-fatal infarction, need of revascularization, stroke and CHF |
Immunoturbidimetry |
No |
GFR = 81.6 ± 22.5 (cystatin C ≥ 1.36 mg/L) GFR = 99.5 ± 20.8 (cystatin C < 1.36 mg/L) p = 0.01 |
Fu et al., 20131818 Fu Z, Xue H, Guo J, Chen L, Dong W, Gai L, et al. Long-term prognostic impact of Cystatin C on acute coronary syndrome octogenarians with diabetes mellitus. Cardiovasc Diabetol. 2013 Nov 1;12:157. doi: 10.1186/1475-2840-12-157. https://doi.org/10.1186/1475-2840-12-157...
|
Unstable angina, NSTEMI, STEMI |
NI |
660/ 81.74 ± 2.54 (group with diabetes) 81.99 ± 2.21 (group without diabetes) |
28 months/ All-cause mortality, myocardial infarction, need of revascularization |
NI |
No |
GFR = 68.67 (55.97-82.14) (with DM) GFR = 72.55 (63.08-81.74) (without DM) p = 0.106 |
Akgul et al., 20131919 Akgul O, Uyarel H, Ergelen M, Pusuroglu H, Gul M, Turen S, et al. Predictive value of elevated cystatin C in patients undergoing primary angioplasty for ST-elevation myocardial infarction. J Crit Care. 2013;28(5):882.e13-20. doi: 10.1016/j.jcrc.2013.03.004. https://doi.org/10.1016/j.jcrc.2013.03.0...
|
STEMI |
Chest pain > 30 min, ST segment elevation in ECG |
475/ 62.8 ± 13.1 (3rd quartile) 52.3 ± 10.5 (1st and 2nd quartiles) |
1 month/ Cardiovascular death, non-fatal infarction, need of revascularization |
Immunoturbidimetry |
No |
GFR = 70.6 ± 24.3 (cystatin C > 1.12 mg/L) GFR = 98.1 ± 22.8 (cystatin C ≤ 1.12 mg/L) p < 0.001 |
Widera et al., 20132020 Widera C, Pencina MJ, Bobadilla M, Reimann I, Guba-Quint A, Marquardt I, et al. Incremental prognostic value of biomarkers beyond the GRACE (Global Registry of Acute Coronary Events) score and high-sensitivity cardiac troponin T in non-ST-elevation acute coronary syndrome. Clin Chem. 2013;59(10):1497-505. doi: 10.1373/clinchem.2013.206185. https://doi.org/10.1373/clinchem.2013.20...
|
Unstable angina, NSTEMI |
Unstable angina: increased levels of cardiac troponin. NSTEMI: increased levels or cardiac troponin, signs of ischemia in ECG, CAD, at least one 50% coronary stenosis |
1146/ 74 (68-80) (with cardiac event) 69 (59-76) (without cardiac event) |
6 months/ All-cause mortality, non-fatal infarction |
Immunoturbidimetry |
No |
Serum creatinine (mg/dL) = 1.20(0.90-1.65) (with cardiac event) Serum creatinine (mg/dL) = 0.93 (0.79-1.13) (without cardiac event) p < 0.001 |
Manzano -Fernández et al., 20122121 Manzano-Fernández S, López-Cuenca Á, Januzzi JL, Parra-Pallares S, Mateo-Martínez A, Sánchez-Martínez M, et al. Usefulness of ß-trace protein and cystatin c for the prediction of mortality in non ST-segment elevation acute coronary syndromes. Am J Cardiol. 2012;110(9):1240-8. doi: 10.1016/j.amjcard.2012.06.027. https://doi.org/10.1016/j.amjcard.2012.0...
|
Unstable angina, NSTEMI |
Chest pain ≥ 10 min within 72 hours before hospital admission and/or ST segment deviation or increased cardiac markers |
226/ 58 ± 11 (1st quartile) 64 ± 10 (2nd quartile) 71 ± 10 (3rd quartile) 76 ± 7 (4th quartile) |
At least 12 months/ All-cause mortality |
Immunonephelometry |
No |
GFR = 92.1 ± 25.7 (1st quartile) GFR = 85.9 ± 19.8 (2nd quartile) GFR = 77.8 ± 14.2 (3rd quartile) GFR = 54.8 ± 16.8 (4th quartile) p ≤ 0.001 |
Ristiniemi et al., 20122222 Ristiniemi N, Lund J, Tertti R, Christensson A, Ilva T, Porela P, et al. Cystatin C as a predictor of all-cause mortality and myocardial infarction in patients with non-ST-elevation acute coronary syndrome. Clin Biochem. 2012;45(7-8):535-40. doi: 10.1016/j.clinbiochem.2012.02.012. https://doi.org/10.1016/j.clinbiochem.20...
|
NSTEMI |
NI |
245/ 62 (10.9) (1st tertile) 69 (9.5) (2nd tertile) 76 (8.8) (3rd tertile) |
12 months/ All-cause mortality non-fatal infarction |
Immunofluorescence |
No |
GFR = 76 (17.4) (1st tertile) GFR = 62 (15.2) (2nd tertile) GFR = 44 (15.5) (3rd tertile) p < 0.0001 |
Silva et al., 20122323 Silva D, Cortez-Dias N, Jorge C, Marques JS, Carrilho-Ferreira P, Magalhães A, et al. Cystatin C as prognostic biomarker in ST-segment elevation acute myocardial infarction. Am J Cardiol. 2012;109(10):1431-8. doi: 10.1016/j.amjcard.2012.01.356. https://doi.org/10.1016/j.amjcard.2012.0...
|
STEMI |
Chest pain at rest > 30 min, ST segment elevation in ECG or left bundle branch block |
151/ 61 ± 12 |
12 months/ All-cause mortality, non-fatal infarction |
Immunonephelometry |
No |
GFR = 96.9 ± 37.1 (no death or infarction) GFR = 80.9 ± 25.3 (death or infarction) p > 0.05 |
Sun et al., 20122424 Sun TW, Xu QY, Yao HM, Zhang XJ, Wu Q, Zhang JY, et al. The predictive value of plasma Cystatin C for acute coronary syndrome treated with percutaneous coronary intervention. Heart Lung. 2012;41(5):456-62. doi: 10.1016/j.hrtlng.2012.04.007. https://doi.org/10.1016/j.hrtlng.2012.04...
|
Unstable angina, NSTEMI, STEMI |
NI |
660 patients/ 62.5 ± 10.5 (with cardiac event) 59.9 ± 10.6 (without cardiac event) |
At least 12 months/ All-cause mortality, non-fatal infarction, need of revascularization, CHF, recurrent chest angina, stroke |
Immunoturbidimetry |
No |
GFR = 96.00 (with cardiac event) GFR = 104.08 (without cardiac event) p = 0.057 |
Kaski et al., 20102525 Kaski JC, Fernández-Bergés DJ, Consuegra-Sánchez L, Fernández JM, García-Moll X, Mostaza JM, et al. A comparative study of biomarkers for risk prediction in acute coronary syndrome-results of the SIESTA (Systemic Inflammation Evaluation in non-ST-elevation Acute coronary syndrome) study. Atherosclerosis. 2010;212(2):636-43. doi: 10.1016/j.atherosclerosis.2010.06.026. https://doi.org/10.1016/j.atherosclerosi...
|
Unstable angina, NSTEMI |
Chest pain at rest > 5 min, and ≥ 1 of these criteria: signs of myocardial ischemia in ECG, CAD and/or myocardial revascularization with PCI or bypass surgery; increased cardiac troponin |
610/ 67.2 ± 10.9 (with cardiac event) 64.5 ± 11.3 (without cardiac event) |
12 months/ All-cause mortality, non-fatal infarction |
Immunonephelometry |
No |
GFR = 74 (58-87) (with cardiac event) GFR = 78 (64-94) (without cardiac event) p = 0.05 |
Taglieri et al., 201066 Taglieri N, Fernandez-Berges DJ, Koenig W, Consuegra-Sanchez L, Fernandez JM, Robles NR, et al; SIESTA Investigators. Plasma cystatin C for prediction of 1-year cardiac events in Mediterranean patients with non-ST elevation acute coronary syndrome. Atherosclerosis. 2010;209(1):300-5. doi: 10.1016/j.atherosclerosis.2009.09.022. https://doi.org/10.1016/j.atherosclerosi...
|
NSTEMI |
Chest pain and at least one of the following criteria: signs of myocardial ischemia in ECG; increased cardiac markers; history of CAD |
525/ 58 (50-66) (1st quartile) 63 (53-70) (2nd quartile) 68 (59-74) (3rd quartile) 72 (67-67) (4th quartile) |
12 months/ Cardiovascular death, non-fatal infarction, unstable angina |
Immunonephelometry |
No |
GFR = 92.3 (80.2-107.4) (1st quartile) GFR = 84.0 (74.9-97.3) (2nd quartile) GFR = 75.1(62.6-89.8) (3rd quartile) GFR = 59.1(47.5-72.9) (4th quartile) p < 0.001 (4th quartile x 1st, 2nd and 3rd quartile) |
Derzhko et al., 20092626 Derzhko R, Plaksej R, Przewlocka-Kosmala M, Kosmala W. Prediction of left ventricular dysfunction progression in patients with a first ST-elevation myocardial infarction--contribution of cystatin C assessment. Coron Artery Dis. 2009;20(7):453-61.
|
STEMI |
Chest pain > 20 min, ST segment elevation in ECG, increased cardiac troponin |
150/ 56.99 ± 11.3 |
6 months/ CHF, non-fatal infarction, unstable angina, all-cause mortality |
Immunonephelometry |
No |
Serum creatinine (mg/dL) (general) = 1.02 ± 0.17 |
Ichimoto et al., 200977 Ichimoto E, Jo K, Kobayashi Y, Inoue T, Nakamura Y, Kuroda N, et al. Prognostic significance of cystatin C in patients with ST-Elevation myocardial infarction. Circ J. 2009;73(9):1669-73. doi: https://doi.org/10.1253/circj.CJ-08-0943
https://doi.org/10.1253/circj.CJ-08-0943...
|
STEMI |
Chest pain > 30 min, ST segment elevation in ECG, CK-MB levels twice greater than upper normal limit |
71/ 61.9 ± 10.4 (cystatin C < 0.96 mg/L) 66.5 ± 12.6 (cystatin C ≥ 0.96 mg/L) |
Approximately 6 months/ All-cause mortality, non-fatal infarction, need of revascularization, stroke, CHF |
Immunoturbidimetry |
No |
Serum creatinine (mg/dL) = 0,93 ± 0,22 (cystatin C ≥ 0,96 mg/L) Serum creatinine (mg/dL) = 0,72 ± 0,14 (cystatin C < 0,96 mg/L) p < 0,01 |
Kilic et al., 20092727 Kilic T, Oner G, Ural E, Yumuk Z, Sahin T, Bildirici U, et al. Comparison of the long-term prognostic value of cystatin C to other indicators of renal function, markers of inflammation and systolic dysfunction among patients with acute coronary syndrome. Atherosclerosis. 2009;207(2):552-8. doi: 10.1016/j.atherosclerosis.2009.05.015. https://doi.org/10.1016/j.atherosclerosi...
|
Unstable angina, NSTEMI, STEMI |
Increased cardiac markers and at least one of these criteria: chest pain; development of pathological Q waves in ECG; signs of ischemia in ECG; PCI; pathological findings of AMI |
160/ 59 ± 10 (without cardiovascular events) 61 ± 10 (with cardiovascular events) |
12 months/ Cardiovascular death, non-fatal infarction, recurrent angina |
Immunoenzymatic assay |
Yes |
GFR = 80 ± 31 (with cardiac events) GFR = 92 ± 35 (without cardiac events) p = 0,03 |
García Acuña et al., 20092828 García Acuña JM, González-Babarro E, Grigorian Shamagian L, Peña-Gil C, Vidal Pérez R, López-Lago AM, et al. Cystatin C provides more information than other renal function parameters for stratifying risk in patients with acute coronary syndrome. Rev Esp Cardiol. 2009;62(5):510-9. doi: 10.1016/S1885-5857(09)71833-X. https://doi.org/10.1016/S1885-5857(09)71...
|
NSTEMI, STEMI |
At least two of these criteria: chest pain: signs of ischemia in ECG; increased cardiac markers |
203/ 59.21 ± 12.26 (cystatin C ≤ 0.95 mg/L) 72.49 ± 10.69 (cystatin C > 0.95 mg/L) |
Approximately 6 months/ Heart failure, no-fatal infarction, cardiovascular death |
Immunonephelometry |
No |
Patients with cystatin C > 0.95 mg/L had a higher frequency of GFR < 60 and a lower frequency of GFR > 90 in comparison with patients with cystatin C levels ≤ 0,95 mg/L p = 0,001 |
Windhausen et al., 200955 Windhausen F, Hirsch A, Fischer J, van der Zee PM, Sanders GT, van Straalen JP, et al; Invasive versus Conservative Treatment in Unstable Coronary Syndromes (ICTUS) Investigators. Cystatin C for enhancement of risk stratification in non-ST elevation acute coronary syndrome patients with an increased troponin T. Clin Chem. 2009;55(6):1118-25. doi: 10.1373/clinchem.2008.119669. https://doi.org/10.1373/clinchem.2008.11...
|
NSTEMI |
Chest pain with increasing intensity or at rest, increased levels of cardiac troponin, and one of these criteria: signs of ischemia in ECG; CAD |
1128/ 57 ± 10 (1st tertile) 62 ± 10 (2nd tertile) 67 ± 9 (3rd tertile) |
3 years (infarction) and 4 years (death)/ All-cause mortality, non-fatal infarction |
Immunonephelometry |
No |
GFR = 102 (87-118) (1st tertile) GFR = 87 (75-103) (2nd tertile) GFR = 68 (56-82) (3rd tertile) p < 0,001 |