0356: Is cystatin C a predictive factor of cardiovascular events in acute coronary syndrome?

BackgroudSerum cystatin C has been proposed as a better marker of glomerular filtration rate than serum creatinine. This study aims to evaluate the relationship between cystatinC, BNP and acute coronary syndrome.MethodsA total of 127 consecutive patients with acute coronary syndrome (ACS) were enrolled in this study. All patients had a normal glomerular filtration rate (GFR) estimated using the MDRD (Modification of Diet in Renal Disease) equation.Serum cystatin C and brain natriuretic peptide (BNP) were determined in all subjects. All patients were followed up for 12 months and adverse cardiovascular events were recorded.ResultsSerum Cys C levels were significantly higher in patients with multi-vessel coronary artery disease (1.17±0.47mg/L vs. 0.93±0.24mg/L, P<0.01). BNP concentrations were significantly associated to left ventricular ejection fraction (LVEF). Patients with systolic heart failure (LVEF < 50%) had higher BNP levels (343.3pg/ml vs. 212.7pg/ml; P<0.001). Serum Cys C and BNP levels were significantly associated to mortality and morbidity post ACS. Receiver operator characteristic (ROC) analyses identified cys C as being the best marker in predicting major adverse cardiac and cerebrovascular events (MACCE: heart failure hospitalizations, recurrent ischemic events and mortality) (AUC=0.622). For high Cys C levels (>1.2mg/L), the risk of occurrence of MACCE was multiplied by 3.35 for BNP levels exceeding 350pg/mL. ROC analyses identified BNP as the best predictor of LV systolic dysfunstion (AUC = 0.784). A BNP value exceeding 133pg/mL had a sensibility of 83% and a specificity of 67% for predicting LV systolic dysfunction during follow-up.ConclusionsCystatin C and BNP are strong predictors for risk of cardiovascular events in acute coronary syndrome