• Stefano De Servi, Giuseppe Mariani, Luigi Piatti, Mario Leoncini, Paolo Rubartelli, Antonio Pitì, Salvatore Curello, Francesco Galdangelo, Pietro Vandoni, Enrico Rossetti, Matteo Mariani, Enrico Boschetti, Gianpietro Re, and Milvia Loznicker.
• aCardiovascular Department, AO 'Ospedale Civile', Legnano bDivision of Cardiology, Manzoni Hospital, Lecco cDivision of Cardiology, Misericordia e Dolce Hospital, Prato dDivision of Cardiology, AO 'Villa Scassi', Genova eDivision of Cardiology, Ospedali Riuniti, Treviglio fCardiology Unit, Spedali Civili, Brescia gDivision of Cardiology, St Antonio Abate Hospital, Gallarate hDivision of Cardiology, Desio Hospital, Desio iDivision of Cardiology, Terni Hospital, Terni jLaboratory Unit, AO 'Ospedale Civile' di Legnano, Italy.
• J Cardiovasc Med (Hagerstown). 2014 Jan 1; 15 (1): 42-7.

BackgroundSerum cystatin C (Cys-C), a good marker of renal function, predicts prognosis in non-ST-elevation acute coronary syndromes (NSTE-ACS). However, no data are available on the time course of Cys-C values after discharge. In this study, Cys-C was measured during admission (ACS sample) and 6 weeks after discharge, and was correlated with troponin (c-TNT), high-sensitivity C-reactive protein (hsCRP), interleukin 6 (IL-6) and the N-terminal portion of the pro-brain natriuretic peptide (proBNP) peptide (NT-proBNP) in a highly selected homogeneous group of NSTE-ACS patients.MethodsIn this prospective, multicentre study, patients with a first NSTE-ACS, single-vessel disease and successful percutaneous coronary interventions (PCIs) had their sera collected, aliquoted and stored at the enrolling site and then shipped for analysis to the clinical chemistry core laboratory.ResultsCys-C values slightly, but significantly, increased from the ACS samples to the 6-week samples. In contrast, hsCRP, NT-proBNP and IL-6 values significantly decreased from the ACS to the 6-week sample. Patients with elevated c-TNT levels had higher hsCRP, NT-proBNP and IL-6 values than patients with normal c-TNT levels in the ACS sample, whereas Cys-C levels were similar in patients with and without elevated c-TNT. Cys-C was highly correlated with estimated glomerular filtration rate in both the ACS and 6-week samples.ConclusionsIn contrast to inflammatory and biochemical stress markers, Cys-C is not affected by the occurrence of myocardial necrosis or by acute left-ventricular impairment, being a reliable marker of renal function during NSTE-ACS.

45 keywords...

hide…