Serum cystatin C is associated with the prognosis in acute myocardial infarction patients after coronary revascularization: a systematic review and meta-analysis

Objective: Our study aimed to assess the association between serum cystatin C levels and prognosis in acute myocardial infarction (AMI) patients after coronary reconstructive surgery. Methods: We searched PubMed, Embase, and Cochrane Library up to January 21, 2022 without language restriction. Outcomes were major cardiovascular events (MACEs) and mortality. The risk ratio (RR) and 95% confidence interval (CI) were merged by random-effect models. Results: We included 8 studies with a total of 7,394 subjects in our meta-analysis. Our meta-analysis showed that higher-level of serum cystatin C levels were associated with higher risk of MACEs (RR = 2.52, 95% CI 1.63–3.89, P < 0.001) and mortality (RR = 2.64, 95% CI 1.66–4.19, P < 0.001) in AMI patients after coronary revascularization. Subgroup analysis showed that the serum cystatin C levels were associated with significantly higher risk of MACEs (RR = 2.72, 95% CI 1.32–5.60, P = 0.006) and mortality (RR = 2.98, 95% CI 1.21–7.37, P = 0.020) in AMI patients after percutaneous coronary intervention (PCI). However, in AMI patients after coronary artery bypass surgery, there were no significantly higher risk of MACEs (RR = 2.41, 95% CI 0.98–5.93, P = 0.05) and mortality (RR = 3.15, 95% CI 0.76–13.03, P = 0.10). Further subgroup analysis showed that this significantly higher risk of MACEs and mortality did not change with the study sample size, study population area or study follow-up time. Conclusion: The meta-analysis demonstrated that higher serum cystatin C levels were associated with significantly higher risk of MACEs and mortality in AMI patients after PCI. It is a biomarker for risk stratification for predicting the prognosis in AMI patients after PCI.