Cargando…
Prognostic ability of cystatin C and homocysteine plasma levels for long-term outcomes in very old acute myocardial infarction patients
BACKGROUND AND AIMS: This study sought to evaluate the prognostic powers of combined use of cystatin C (Cys C) and homocysteine (Hcy) at predicting adverse events of patients >80 years old with acute myocardial infarction (AMI). PATIENTS AND METHODS: The analysis involved 753 patients >80 year...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove Medical Press
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6037277/ https://www.ncbi.nlm.nih.gov/pubmed/30013331 http://dx.doi.org/10.2147/CIA.S151211 |
_version_ | 1783338305985708032 |
---|---|
author | Fu, Zhenhong Yang, Xia Shen, Mingzhi Xue, Hao Qian, Geng Cao, Feng Guo, Jun Dong, Wei Chen, Yundai |
author_facet | Fu, Zhenhong Yang, Xia Shen, Mingzhi Xue, Hao Qian, Geng Cao, Feng Guo, Jun Dong, Wei Chen, Yundai |
author_sort | Fu, Zhenhong |
collection | PubMed |
description | BACKGROUND AND AIMS: This study sought to evaluate the prognostic powers of combined use of cystatin C (Cys C) and homocysteine (Hcy) at predicting adverse events of patients >80 years old with acute myocardial infarction (AMI). PATIENTS AND METHODS: The analysis involved 753 patients >80 years old undergoing coronary angiography for chest pain in China from January 2006 to December 2012. Kaplan–Meier method was used for survival and major adverse cardiac events (MACE) rates. Multivariate Cox regression was performed to identify mortality predictors. Receiver operating characteristic curve analysis was performed to predict the cutoff values of Cys C and Hcy for all-cause mortality. RESULTS: The duration of follow-up was 40–116 months (median, 63 months; interquartile range, 51–74 months). The long-term survival and event-free survival rates of AMI patients were significantly lower than those of unstable angina pectoris patients (P<0.05), and were significantly different according to the tertile concentration of Cys C of AMI patients (P<0.01). Cys C and Hcy were independent risk factors for long-term all-cause mortality (odds ratio [OR] =3.72 [2.27–6.09]; OR =1.59 [1.04–2.61]) and MACE (OR =2.83 [1.82–4.40]; OR =1.09 [1.04–1.21]) of AMI patients. The predictive cutoff value of Cys C was 1.815 mg/L (82.8%, 86.4%) and that of Hcy was 15.06 μmol/L (84.4%, 83.1%) in AMI patients. Combined use of both biomarker’s cutoff values further increased the sensitivity and specificity of all-cause mortality. CONCLUSION: Cys C is a strong independent predictor of long-term all-cause death and MACE in very old AMI patients. The combined use of Cys C and Hcy further improves the predictive accuracy. |
format | Online Article Text |
id | pubmed-6037277 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-60372772018-07-16 Prognostic ability of cystatin C and homocysteine plasma levels for long-term outcomes in very old acute myocardial infarction patients Fu, Zhenhong Yang, Xia Shen, Mingzhi Xue, Hao Qian, Geng Cao, Feng Guo, Jun Dong, Wei Chen, Yundai Clin Interv Aging Original Research BACKGROUND AND AIMS: This study sought to evaluate the prognostic powers of combined use of cystatin C (Cys C) and homocysteine (Hcy) at predicting adverse events of patients >80 years old with acute myocardial infarction (AMI). PATIENTS AND METHODS: The analysis involved 753 patients >80 years old undergoing coronary angiography for chest pain in China from January 2006 to December 2012. Kaplan–Meier method was used for survival and major adverse cardiac events (MACE) rates. Multivariate Cox regression was performed to identify mortality predictors. Receiver operating characteristic curve analysis was performed to predict the cutoff values of Cys C and Hcy for all-cause mortality. RESULTS: The duration of follow-up was 40–116 months (median, 63 months; interquartile range, 51–74 months). The long-term survival and event-free survival rates of AMI patients were significantly lower than those of unstable angina pectoris patients (P<0.05), and were significantly different according to the tertile concentration of Cys C of AMI patients (P<0.01). Cys C and Hcy were independent risk factors for long-term all-cause mortality (odds ratio [OR] =3.72 [2.27–6.09]; OR =1.59 [1.04–2.61]) and MACE (OR =2.83 [1.82–4.40]; OR =1.09 [1.04–1.21]) of AMI patients. The predictive cutoff value of Cys C was 1.815 mg/L (82.8%, 86.4%) and that of Hcy was 15.06 μmol/L (84.4%, 83.1%) in AMI patients. Combined use of both biomarker’s cutoff values further increased the sensitivity and specificity of all-cause mortality. CONCLUSION: Cys C is a strong independent predictor of long-term all-cause death and MACE in very old AMI patients. The combined use of Cys C and Hcy further improves the predictive accuracy. Dove Medical Press 2018-07-03 /pmc/articles/PMC6037277/ /pubmed/30013331 http://dx.doi.org/10.2147/CIA.S151211 Text en © 2018 Fu et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. |
spellingShingle | Original Research Fu, Zhenhong Yang, Xia Shen, Mingzhi Xue, Hao Qian, Geng Cao, Feng Guo, Jun Dong, Wei Chen, Yundai Prognostic ability of cystatin C and homocysteine plasma levels for long-term outcomes in very old acute myocardial infarction patients |
title | Prognostic ability of cystatin C and homocysteine plasma levels for long-term outcomes in very old acute myocardial infarction patients |
title_full | Prognostic ability of cystatin C and homocysteine plasma levels for long-term outcomes in very old acute myocardial infarction patients |
title_fullStr | Prognostic ability of cystatin C and homocysteine plasma levels for long-term outcomes in very old acute myocardial infarction patients |
title_full_unstemmed | Prognostic ability of cystatin C and homocysteine plasma levels for long-term outcomes in very old acute myocardial infarction patients |
title_short | Prognostic ability of cystatin C and homocysteine plasma levels for long-term outcomes in very old acute myocardial infarction patients |
title_sort | prognostic ability of cystatin c and homocysteine plasma levels for long-term outcomes in very old acute myocardial infarction patients |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6037277/ https://www.ncbi.nlm.nih.gov/pubmed/30013331 http://dx.doi.org/10.2147/CIA.S151211 |
work_keys_str_mv | AT fuzhenhong prognosticabilityofcystatincandhomocysteineplasmalevelsforlongtermoutcomesinveryoldacutemyocardialinfarctionpatients AT yangxia prognosticabilityofcystatincandhomocysteineplasmalevelsforlongtermoutcomesinveryoldacutemyocardialinfarctionpatients AT shenmingzhi prognosticabilityofcystatincandhomocysteineplasmalevelsforlongtermoutcomesinveryoldacutemyocardialinfarctionpatients AT xuehao prognosticabilityofcystatincandhomocysteineplasmalevelsforlongtermoutcomesinveryoldacutemyocardialinfarctionpatients AT qiangeng prognosticabilityofcystatincandhomocysteineplasmalevelsforlongtermoutcomesinveryoldacutemyocardialinfarctionpatients AT caofeng prognosticabilityofcystatincandhomocysteineplasmalevelsforlongtermoutcomesinveryoldacutemyocardialinfarctionpatients AT guojun prognosticabilityofcystatincandhomocysteineplasmalevelsforlongtermoutcomesinveryoldacutemyocardialinfarctionpatients AT dongwei prognosticabilityofcystatincandhomocysteineplasmalevelsforlongtermoutcomesinveryoldacutemyocardialinfarctionpatients AT chenyundai prognosticabilityofcystatincandhomocysteineplasmalevelsforlongtermoutcomesinveryoldacutemyocardialinfarctionpatients |