The association between elevated cystatin C levels with myocardial infarction: a meta-analysis

Objective: Cystatin C is a well established marker of kidney function. There is evidence that cystatin C concentrations are also associated with myocardial infarction. The purpose of the present study is to clarify the link between cystatin C with myocardial infarction using a meta-analysis approach. Methods: We searched articles indexed in the Pubmed and Sciencedirect published as of August 2015 that met our predefined criteria. A meta-analysis was used to pool estimates of the multivariate adjusted relative risk (RR) with 95% confidence interval (CI), of the association between cystatin C and subsequent risk of myocardial infarction. Results: Four eligible articles with 10491 subjects from 5 cohort studies were considered in the analysis. Overall, the random-effects meta-analysis results indicated that the highest cystatin C category versus lowest was associated with greater risk of myocardial infarction (RR, 1.78; 95% CI, 1.27 to 2.49; P= 0.001). No evidence of publication bias was observed. Conclusions: This meta-analysis showed that cystatin C is strongly and independently associated with subsequent risk of myocardial infarction. Further investigation is warranted to clarify whether measurement of cystatin C can usefully reduce the myocardial infarction beyond established predictors already in clinical use.