ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Atherosclerosis and Vascular Medicine
CysC as a Predictor of Left Ventricular Remodeling and Major Adverse Cardiovascular Events in Patients with Acute Myocardial Infarction
Provisionally accepted
- The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
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Background: Percutaneous coronary intervention (PCI) is the primary revascularization method for acute myocardial infarction (AMI); however, patients remain at significant risk of developing left ventricular remodeling (LVR), which is closely associated with major adverse cardiovascular events (MACE). This study evaluated cystatin C (CysC) as a potential biomarker for LVR and MACE after PCI in AMI patients. Methods: A total of 168 AMI patients who underwent PCI were followed for 6 months. Transthoracic echocardiography was performed at admission and 6-month follow-up. The endpoints were LVR and MACE. Multivariable logistic regression analysis was used to identify factors associated with LVR, while Cox proportional hazards regression was employed for time-to-MACE analysis. Variables with P < 0.1 in univariate analyses were included in multivariate models. Stepwise forward selection was applied to construct the final models, with adjustment for potential confounders. Results: 22% of patients developed LVR and 18.6% experienced MACE. Multivariate regression analysis identified CysC as independently associated with both LVR and MACE after PCI. The AUC for CysC in predicting LVR and MACE was 0.757 and 0.707, respectively. Adding CysC to conventional risk prediction models improved their discriminatory accuracy. Internal validation using bootstrap sampling (1,000 replications) confirmed model reliability. Kaplan-Meier analysis stratified by CysC tertiles demonstrated a significant association between increasing CysC levels and higher incidence of MACE (log-rank P=0.002). Conclusion: CysC was independently associated with LVR and MACE after PCI in patients with AMI, highlighting its potential value as a biomarker for early identification of high-risk patients and guiding targeted therapeutic interventions.
Keywords: acute myocardial infarction急性心肌梗死, Cystatin C 半胱氨酸蛋白酶抑制剂 C, left ventricular remodeling左心室重构, major adversecardiovascular events主要不良心血管事件, percutaneous coronary intervention经皮冠状动脉介入治疗
Received: 03 Sep 2025; Accepted: 27 Nov 2025.
Copyright: © 2025 An, Yuan, Lu, Liu and Pan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Defeng Pan
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