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Previous studies indicated that Cystatin C improves prediction of adverse events in patients with coronary artery disease. However, prognostic implications of Cystatin C in myocarditis remains unknown. This study aimed to investigate the predictive value of Cystatin C for the adverse clinical outcome in patients with suspected acute myocarditis.
A total of 72 patients (33±12 years old, 47 males) with suspected acute myocarditis defined by current ESC recommendations was included. Serum cystatin C was measured via an immunoturbidimetric technique. The endpoints were all-cause mortality and a combined endpoint of cardiac mortality and admission due to heart failure.
A mean follow-up of 224±87 days was performed in all patients. Event rate was 9.7% for all-cause mortality and 29.2% for the combined endpoint of cardiac mortality and admission due to heart failure. Cystatin C was positively associated with increased risk of both all-cause mortality (p=0.014) and the combined endpoint (p<0.001). After adjustment for confounding risk factors (age, gender, hypertension, diabetes, renal function, hypercholesterolemia, smoking, and previous cardiovascular diseases), multivariate logistic regression analysis showed that Cystatin C was an independent predictor of all-cause mortality (odds ratio 1.59;95% CI 1.14-2.31; p<0.001) and the combined endpoint (odds ratio 1.88;95% CI 1.43-2.38; p<0.001).
Serum Cystatin C independently predicts the adverse clinical outcome in patients with suspected acute myocarditis.